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Test Findings
 
 

Increased Urine Urobilinogen

 
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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.
  • BilirubinUrobilinogen
    NormalNegativeWeak Positive
    HaemolysisNegativePositive
    Hepatic DiseasePositivePositive
    CholestasisPositiveNegative
    • 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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