Elevated Urobilinogen in Crigler-Najjar?

[Gooby]

FA2014 page 363

Elevated urine urobilinogen is seen in hemolytic anemia, physiologic (newborns), Crigler-Najjar, and Gilbert's.

I understand how you get elevated urobilinogen in hemolytic anemia, since conjugation potential is still intact. I don't understand how you get elevated urobilinogen in the absence of UDP-glucouronyltransferase.

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[surgok]

Depends on if it's type I or type II. Type II is more benign so you would see urobilinogen.

 

[Fatalis]

Depends on if it's type I or type II. Type II is more benign so you would see urobilinogen.

pimp question: what drug do we use to increase UDP for type 2 pnts?

 

[NeuroLAX]

pimp question: what drug do we use to increase UDP for type 2 pnts?

Phenobarbital. We were told that it is not used much.

 

[Gooby]

I still don't understand. How can you have HIGHER UROBILINOGEN when your ability to conjugate bilirubin is absent or impaired to any severity.

 

[Donald Juan]

I still don't understand. How can you have HIGHER UROBILINOGEN when your ability to conjugate bilirubin is absent or impaired to any severity.

I'm having trouble with this, too. On FA2014's proposed errata page, there are about 3 remarks about this specific topic, but no official word from them on changing it yet. Nowhere in my notes or textbooks can I find specific info on urobilinogen in Crigler-najar, Gilbert's, or physiologic jaundice of newborn. However, it only makes sense that in these disorders urobilinogen would be low.

http://www.firstaidteam.com/proposed-step-1-errata-view-2

 

[Brain Bucket]

a valid message.

 

[lp430]

In Pathoma, it says that urobilinogen is produced from conjugated bilirubin by the intestinal flora. If you can't conjugate bilirubin via UGT, I don't think you can have elevated urobilinogen.

 

[Fungi121]

sweet, glad to hear we're all on the same page about this!

 

[CherryRedDracul]

You wouldn't.

This. We'll probably see the correction in the next wave of errata. Bottom line, it makes no friggin sense that urobilinogen would increase if the production of conjugated bilirubin decreases. You can go ahead and make the correction.