A 20-year-old male complained of red-brown urine and muscle pain 3 hours after h

Question

A 20-year-old male complained of red-brown urine and muscle pain 3 hours after his early practice run for the Los Angeles Marathon. A physical exam done in the ER was unremarkable except for muscle tenderness. A routine physical performed two weeks earlier indicated he was in good health. Color Appearance Clear Specific Gravity 1.030 Brown 6.5 Protein Glucose Ketones Bilirubin Blood Urobilinogen 0.1 mg/dl Nitrite Leukocyte Esterase Neg Neg Large 3+ Neg 2+ diffuse Neg Microscopic Urinalysis WBC/hpf 0-1/hpf RBC/hpf0-1/hpf Casts Other 6-10 hyaline/lpf Occasional transitional cells Discuss the case and answer the questions. 1. What are the causes of red-brown urine? 2. In light of the patient's recent activities, how would you interpret the positive UA result? 3. Does this patient have renal disease? 4. What recommendation would you make to the health care provider about the UA results?

Explanation / Answer

The cause of red-brown urine may be; thalassemia as the bacterial infection is negative due to negative Leukocyte esterase. Since this case appears to be a thalassemia case; the patient’s recent activity i.e. the physical activity may have worsened his condition as is the case in this disorder. The hematuria observed in this thalassemia patients may be due to the result of tubular damage induced by iron deposition, hypercalciuria, hyperuricosuria, and deferoxamine, (Kang, 2013). Thus renal dysfunction is indicated. The recommendation that should be made to the healthcare provider in this situation is to make the patient consider the; Chronic transfusion therapy for extending life expectancy for this patients,(Tubman, 2015)

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