Honors Urinalysis Home Middle Aged Woman Case Study Teenage Boy Case Study |
Middle-Aged Woman with Dark Urine | ||||||||||||||||||||||||
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1. From what conditon is the patient most likely suffering? This patient is most likely suffering from some form of hemoglobinuria, which is a condition where red blood cells are prematurely lysed and excess hemoglobin travels around the plasma and into the urine, giving it the characteristic red/brown color. The presence of hemosiderin granules and absence of haptoglobin indicates a severe acute intravascular hemolytic episode about 2 to 3 days ago. The patient's age and sex point to Autoimmune Hemolytic Anemia (AIHA), which can be due to an immune disorder, toxic chemicals and drugs, antiviral agents, physical damage, penicillin, and infections. The reason no red blood cells showed up in the microscopic analysis is because they have all been lysed. A 35 year old woman went to the doctor complaining of fatigue, shortness of breath, and dark urine. Her skin was very pale, and the whites of her eyes were slightly yellow. She reported recently having a sinus infection which was treated with penicillin. Urinalysis results are:
Microscopic amorphous 2+ hemosiderin granules present Upon receiving the urinalysis results, the physician orders a blood test for haptoglobin which comes back less than 5 mg/dL (reference range = 26-185 mg/dL). |