Abnormally colored urine

Background

The urine can help guide the toxicologic differential in a poisoned patient[1]

Differential Diagnosis

Red Urine

  • Hematuria
  • Hemoglobinuria
  • Porphyria
  • Myoglobinuria (rhabdomyolysis)
  • Foods
    • Blackberries
    • Beets
    • Blackberries
    • Rhubarb
    • Food coloring
    • Fava beans
  • Drugs
    • Laxatives
    • Phenophthalein
    • Rifampin
    • Doxorubicin
    • Deferoxamine
    • Ibuprofen
    • Chloroquine
    • Hydroxocobalamin

Black

  • Methyldopa
  • Betadine
  • Melanoma
  • Cresol
  • Iiron
  • Laxatives (cascara, senna)
  • L-dopa
  • Methocarbamol
  • Metronidazole
  • Nitrofurantoin
  • Sorbitol

Orange

Purple

  • Phenolphthalein
  • Purple Urine Bag Syndrome[2][3]

Brown

  • Levodopa
  • Metronidazole
  • Nitrofurantoin
  • Iron sorbitol
  • Chloroquine
  • Methyldopa
  • Acetaminophen (overdose)
  • Niridazole
  • Fava beans
  • Rhubarb

Blue/Green

  • Amitryptiline
  • Indomethicin
  • Pseudomonas
  • Methylene blue
  • Clorets breath mints
  • Cimetidine
  • Flupirtine
  • Methocarbamol
  • Metoclopramide
  • Promethazine
  • Propofol
  • Tetrahydronaphthalene
  • Zaleplon

Hematuria vs Myoglobinuria

See Also

Rhabdomyolysis

External Links

Poison Review - What Color is Your Urine?

References

  1. Aycock RD Kass DA. Abnormal urine color. South Med J. 2012 Jan;105(1):43-7
  2. Barlow, G et al. "Purple urine bags". Lancet 1 (8062): 502.
  3. Tan, C et al. "Purple urine bag syndrome". Canadian Medical Association Journal 179 (5): 491.