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Biliary Atresia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Biliary atresia is also known as extrahepatic ductopenia and progressive obliterative cholangiopathy. It is a childhood disease of the liver in which one or more bile ducts are inflamed and blocked or abnormally narrow. This prevents bile from draining out of the liver into the intestines. It is one of the leading causes of cholestasis in a newborn, the foremost reason for cirrhosis and liver-related death in children. Biliary atresia first manifests during the first two to eight weeks of life with jaundice and pale (clay-colored) stools. Additional symptoms such as dark urine along with irritability and weight loss may also be present. Surgical intervention via Kasai portoenterostomy is the medical treatment of choice.1
Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Haematuria is the presence of blood in the urine and, when severe, may be visible as frank haematuria. Causes include renal stones, glomerulonephritis and urinary tract tumours. Frothy urine suggests a high protein content. Dark urine can occur with myoglobinuria because of muscle damage in rhabdomyolysis or haemoglobinuria when there is haemolysis.
Liver disorders and gallstones
Published in Martin Andrew Crook, Clinical Biochemistry & Metabolic Medicine, 2013
Unconjugated bilirubin is normally all protein bound and is not water soluble and therefore cannot be excreted in the urine. Patients with unconjugated hyperbilirubinaemia do not have bilirubinuria (‘acholuric jaundice’) such as Gilbert’s syndrome. Conjugated bilirubinaemia is one of the earliest signs of impaired hepatic excretion. In most cases of jaundice in adults, both conjugated and unconjugated fractions of bilirubin are increased in plasma but conjugated bilirubin predominates. Conjugated bilirubin is water soluble and is less strongly protein bound than the unconjugated form, and therefore can be excreted in the urine. Bilirubinuria is always pathological. Dark urine may be an early sign of some forms of hepatobiliary disease.
Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review
Published in The Physician and Sportsmedicine, 2023
Yoshio Masuda, Rachel Wam, Benjamin Paik, Clara Ngoh, Andrew MTL Choong, Jun Jie Ng
The time interval between the spinning session and onset of symptoms ranged from 0 to 2 days, with a combined mean of 0.8 ± 0.5 days. On the other hand, the time interval between spinning session to clinical presentation at a medical facility ranged from 0 to 5 days, with a combined mean of 3.1 ± 1.5 days. Of the 18 studies [10–12,26,27,30–34,37–44] with individual patient data, 17 (34%) patients presented 48 hours or less after the spinning session, whereas 33 (66%) patients presented after 48 hours. The most commonly reported presenting symptoms were myalgia and dark urine. In the relevant studies, 69.1% of patients reported myalgia and 56.7% reported dark urine [9,23–29,31–34,36,37,39–41]. Only 16.5% of patients reported muscle weakness at initial presentation. Consequently, the most common findings on clinical examination were muscle tenderness, muscle swelling, and reduced power. The most commonly affected muscle group was the thigh (97.7%). A summary of the study and patient characteristics can be found in Table 1.
The first Chinese case of unstable Hemoglobin Santa Ana detected by capillary electrophoresis: a case report and literature review
Published in Hematology, 2022
Li Du, Danqing Qin, Jicheng Wang, Cuize Yao, Juan Zhu, Hao Guo, Tenglong Yuan, Jie Liang, Aihua Yin
Intrinsic disorders of erythrocytes are a common cause of hemolytic anemia in children and adults [10]. Patients typically present symptoms of hemolytic anemia and dark urine should be needed to investigate this aspect. Due to the simple procedure, red cell enzyme assays should be performed preferentially. Once disorders of erythrocyte metabolism have been ruled out, unstable hemoglobinopathies should be considered. It is well known that the CE method is suitable for the detection and quantification of hemoglobin variants and thalassemias, with better performance than HPLC. In our study, we for the first time showed that hemoglobin Santa Ana can be detected by CE. This unstable hemoglobin is first described herein as a de novo variant in the Chinese population. In summary, our findings will be useful to assist in genetic counselling and prenatal diagnosis.
Synthetic cathinone mixtures induced prolonged psychotic symptoms with rhabdomyolysis and neurocognitive dysfunction
Published in Journal of Substance Use, 2022
Chia-Heng Lin, Chia-Hsiang Chan
The evaluation indicated that the patient was hostile and hyperactive and had somatic delusions that his organs were displaced. Hyperthermia, paresis, and dark urine were also noted. Laboratory studies revealed elevated serum creatinine phosphokinase (51.69 µkat/L) and leukocytosis (12.03 × 109/L). A urine drug test revealed cathinone derivatives, including eutylone, methylone, mephedrone, and ephylone. The patient received intravenous rehydration and oral antipsychotic agent quetiapine, titrated from 50 to 200 mg daily for a month. The psychotic symptoms and physical complications were alleviated. Before discharge, the Wechsler Adult Intelligence Scale-III and the Bender Visual-Motor Gestalt Test were administered and compared with the history of high school education, which revealed executive function impairments, cognitive impulsivity, and borderline intellectual functioning.