Abnormally colored urine

Background

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

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
• Uric acid crystalluria (neonates)

Black

1. Methyldopa
2. Betadine
3. Melanoma
4. Cresol
5. Iiron
6. Laxatives (cascara, senna)
7. L-dopa
8. Methocarbamol
9. Metronidazole
10. Nitrofurantoin
11. Sorbitol

Orange

1. Pyridium
2. Rifampin
3. Vitamin A
4. Vitamin B12
5. Carrots
6. Beets
7. Bile pigments

Purple

1. Phenolphthalein
2. Purple Urine Bag Syndrome

Brown

1. Levodopa
2. Metronidazole
3. Nitrofurantoin
4. Iron sorbitol
5. Chloroquine
6. Methyldopa
7. Acetaminophen (overdose)
8. Niridazole
9. Fava beans
10. Rhubarb

Blue/Green

1. Amitryptiline
2. Indomethicin
3. Pseudomonas
4. Methylene blue
5. Clorets breath mints
6. Cimetidine
7. Flupirtine
8. Methocarbamol
9. Metoclopramide
10. Promethazine
11. Propofol
12. Tetrahydronaphthalene
13. Zaleplon

Hematuria

UA = +Blood with +RBCs

Myoglobinuria

UA = +Blood with -RBCs

See Also

Rhabdomyolysis

External Links

Poison Review

Sources

Aycock R. et al. Abnormal Urine Color. South Med J. 2012 Jan;105(1):43-7