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Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication

Drug-induced changes in urine color induced by drugs may have clinical significance. Pink urine syndrome (PUS), which has been associated with urinary uric acid (UA) disorders, is most frequently reported in patients with morbid obesity undergoing gastric bypass surgery and/or from propofol anesthes...

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Autores principales: Zhang, Fangwei, Zhu, Xing, Zhang, Hongbo, Xu, Lin, Wu, Weiguo, Hu, Xuelei, Zhou, Haipeng, Wei, Penghui, Li, Jianjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241095/
https://www.ncbi.nlm.nih.gov/pubmed/34211398
http://dx.doi.org/10.3389/fphar.2021.686619
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author Zhang, Fangwei
Zhu, Xing
Zhang, Hongbo
Xu, Lin
Wu, Weiguo
Hu, Xuelei
Zhou, Haipeng
Wei, Penghui
Li, Jianjun
author_facet Zhang, Fangwei
Zhu, Xing
Zhang, Hongbo
Xu, Lin
Wu, Weiguo
Hu, Xuelei
Zhou, Haipeng
Wei, Penghui
Li, Jianjun
author_sort Zhang, Fangwei
collection PubMed
description Drug-induced changes in urine color induced by drugs may have clinical significance. Pink urine syndrome (PUS), which has been associated with urinary uric acid (UA) disorders, is most frequently reported in patients with morbid obesity undergoing gastric bypass surgery and/or from propofol anesthesia use in those who potentially have preexisting UA metabolism disorders. However, PUS has rarely occurred following exposure to propofol in non-obese patients, and literature on long-term follow-up after PUS is scarce. We report a case of PUS induced by propofol in a previously healthy non-obese woman after undergoing thoracoscopic wedge resection of pulmonary nodules under general anesthesia using propofol. The patient suddenly developed pink urine 4 h after surgery. A pink sediment rapidly precipitated at the bottom of the test tube following centrifugation of the urine. Amorphous, colorless UA-like crystals were identified under a polarizing microscope. The diagnosis of PUS was confirmed by examining the urinary UA concentration. The patient recovered and as followed-up for 1 month, during which she did not experience any urinary complications. To our knowledge, this is the first report to describe in detail a case of PUS caused by propofol in a non-obese patient with follow-up. PUS is usually benign and can resolve by rapidly on administering lactated Ringer’s solution; however, the potential risk of urinary complications, particularly UA lithiasis, should be fully realized.
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spelling pubmed-82410952021-06-30 Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication Zhang, Fangwei Zhu, Xing Zhang, Hongbo Xu, Lin Wu, Weiguo Hu, Xuelei Zhou, Haipeng Wei, Penghui Li, Jianjun Front Pharmacol Pharmacology Drug-induced changes in urine color induced by drugs may have clinical significance. Pink urine syndrome (PUS), which has been associated with urinary uric acid (UA) disorders, is most frequently reported in patients with morbid obesity undergoing gastric bypass surgery and/or from propofol anesthesia use in those who potentially have preexisting UA metabolism disorders. However, PUS has rarely occurred following exposure to propofol in non-obese patients, and literature on long-term follow-up after PUS is scarce. We report a case of PUS induced by propofol in a previously healthy non-obese woman after undergoing thoracoscopic wedge resection of pulmonary nodules under general anesthesia using propofol. The patient suddenly developed pink urine 4 h after surgery. A pink sediment rapidly precipitated at the bottom of the test tube following centrifugation of the urine. Amorphous, colorless UA-like crystals were identified under a polarizing microscope. The diagnosis of PUS was confirmed by examining the urinary UA concentration. The patient recovered and as followed-up for 1 month, during which she did not experience any urinary complications. To our knowledge, this is the first report to describe in detail a case of PUS caused by propofol in a non-obese patient with follow-up. PUS is usually benign and can resolve by rapidly on administering lactated Ringer’s solution; however, the potential risk of urinary complications, particularly UA lithiasis, should be fully realized. Frontiers Media S.A. 2021-06-15 /pmc/articles/PMC8241095/ /pubmed/34211398 http://dx.doi.org/10.3389/fphar.2021.686619 Text en Copyright © 2021 Zhang, Zhu, Zhang, Xu, Wu, Hu, Zhou, Wei and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Zhang, Fangwei
Zhu, Xing
Zhang, Hongbo
Xu, Lin
Wu, Weiguo
Hu, Xuelei
Zhou, Haipeng
Wei, Penghui
Li, Jianjun
Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication
title Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication
title_full Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication
title_fullStr Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication
title_full_unstemmed Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication
title_short Case Report: Pink Urine Syndrome Following Exposure to Propofol: A Rare, Impressive but Benign Complication
title_sort case report: pink urine syndrome following exposure to propofol: a rare, impressive but benign complication
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241095/
https://www.ncbi.nlm.nih.gov/pubmed/34211398
http://dx.doi.org/10.3389/fphar.2021.686619
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