Increased Urine Urobilinogen
September 10th, 2020
Overview
Bilirubin is converted to urobilinogen by bacteria within the intestines, reabsorbed and excreted by the kidneys.
Normal Range
- 0.2 - 1.0mg/dL
Urobilinogen is normally present in small amounts in the urine, though an increase in urine urobilinogen suggests an excess of conjugated or unconjugated bilirubin.
An increase in urine urobilinogen cannot occur in the context of cholestasis, as conjugated bilirubin is unable to pass into the gut and be reabsorbed.
| Bilirubin | Urobilinogen | |
| Normal | Negative | Weak Positive |
| Haemolysis | Negative | Positive |
| Hepatic Disease | Positive | Positive |
| Cholestasis | Positive | Negative |
Causes of Increased Urine Urobilinogen
- Haemolysis - immune, thrombotic microangiopathy, mechanical, inherited, infection, hypersplenism, drugs
- Acute hepatitis - viral hepatitis, HSV, EBV, CMV, VZV, alcoholic hepatitis, drug-induced hepatitis, ischaemic hepatitis, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson's disease
- Cirrhosis - chronic hepatitis B or C, alcoholic liver disease, non-alcoholic fatty liver disease, autoimmune hepatitis, primary biliary cirrhosis, chronic bile duct obstruction, primary sclerosing cholangitis, haemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, hepatocellular carcinoma, sarcoidosis, glycogen storage disease type IV, methotrexate, methyldopa, amiodarone, Budd-Chiari syndrome, right heart failure
- Pernicious anaemia
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