Yellow urine like strong tea



The prominent symptoms of jaundice hepatitis B are general fatigue, loss of appetite, nausea, vomiting, and especially disgusting greasy food. The upper abdomen is full of suffocation and the yellow urine is like strong tea. It may be hemoglobinuria caused by liver disease caused by excessive blood bilirubin or intravascular hemolysis (such as paroxysmal nocturnal hemoglobinuria). The former can be diagnosed by liver function, the latter is diagnosed: laboratory test: acidified serum hemolysis test (Ham test), sugar water test, snake venom factor hemolysis test, urinary occult blood or urinary hemosiderin.



The urine color of people is pale yellow. It is clear when it is cold, and it is yellow when it is hot. This is related to how much sweating and drinking, but it can also change with the diet. If you take an acidic diet, the urine color is deep. If the diet is alkaline, the urine color is light. Sometimes a few tablets of riboflavin tablets are taken orally, and the urine color will also appear dark yellow. Changes like these urine colors are extremely short-lived and will soon recover on their own.

Yellow-brown urine should be differentiated from bilirubin urine or urinary bile urine. Bilirubinuria is often blocked by inflammation, tumors, and stones in the biliary tract of the liver or outside the liver, causing increased biliary pressure, rupture of the bile duct, and bile spillage, causing bilirubin sodium to enter the systemic circulation. When the amount of bilirubin sodium exceeds a certain amount, bilirubinuria occurs. Urinary bile urine, often due to liver damage, causing an increase in intestinal absorption of urinary bile, into the urine, urinary bile urine. Or a patient with hemolytic anemia, because a large number of red blood cells are destroyed, a large amount of urinary bile is absorbed into the portal vein through the intestinal wall. Since the liver cannot convert excessive urinary bile into bilirubin, urinary bile urine also occurs.


an examination

Related inspection

Hepatitis B virus anti-pre-S2 antibody hepatitis B virus pre-S2 antigen

First, the early stage of jaundice

The time from the start of the patient's symptoms to the appearance of jaundice is approximately several days to two weeks. At the onset of the disease, the patient often feels chills and fever, and the body temperature is about 38 °C. A few patients can continue to heat for several days. The more prominent symptoms are fatigue, loss of appetite, nausea, vomiting, especially disgusting greasy food. The upper abdomen is full of suffocation, yellow urine is like strong tea, and stool is thin or constipated. At this stage, due to individual differences, patient performance is complex and diverse, it is easy to be misdiagnosed. Special attention should be paid to patients with upper respiratory tract inflammation, similar to a cold. Some patients may be mistaken for wetness with joint pain. There are also a few people who have severe abdominal pain and mistaken for acute abdomen. There are also a few people who can wait for measles. At the end of this period, the body can be found in the liver area with sputum pain and tenderness. More than half of the patients can touch the liver under the costal margin, serum alanine aminotransferase (ALT) is significantly elevated, and urinary bilirubin is positive. Hepatitis B surface antigen positive, hepatitis B core antibody immunoglobulin M (anti-HBcIgM) positive. In this period, the blood, urine, and vomit of the patient contain a large amount of hepatitis virus, which is highly contagious.

Second, the yellow period

The patient's sclera (white eye part), skin and mucous membrane yellow stained, peaked in a few days to 2 weeks. At this time, the fever gradually subsided, and the digestive symptoms were further aggravated. The liver is swollen and tender, and about 10% - 35% of the patients' spleen is also swollen and can be touched. The blood leukocytes were normal or slightly low, and the liver function test was abnormally abnormal. The serum bilirubin was above 17 mol/L (1.0 mg). This period generally lasts about 2-6 weeks.

Third, the recovery period

The jaundice gradually subsided, the symptoms gradually disappeared, the liver and splenomegaly gradually retracted, and the liver function tends to return to normal, with a period of about 4 weeks.


Differential diagnosis

Pediatric urine blue: is a complication of pediatric blue diaper syndrome. General performance, may have anorexia, vomiting, constipation, irritability, weight loss, visual loss and other symptoms. The child was pale, pygmy, flattened in the nose, with internal epithelium, nystagmus, squinting, optic disc edema, and optic atrophy.

Green urine: Green urine is discharged when a large number of anti-inflammatory drugs or Pseudomonas aeruginosa are born in the urine.

Black urine: black urine is relatively rare, often occurs in patients with acute intravascular hemolysis, such as falciparum malaria, medically known as black urine fever, is one of the most serious complications of falciparum malaria. The patient's plasma contains a large amount of free oxygen, hemoglobin and oxyhemoglobin, which are dark red or black in urine. A small number of patients who take levodopa, cresol, benzoquinone, etc., will also cause black urine, which will disappear after stopping the drug. According to foreign reports, patients with paroxysmal myoglobinuria will also explode brown-black urine after exercise, accompanied by muscle weakness, which can gradually develop into dysentery. In addition, black urine can also be seen in phenol poisoning, black tumor, and urinary acidosis.

Brown urine (like soy sauce color): can be seen in acute nephritis, acute jaundice hepatitis, kidney crush injury, extensive burns, hemolytic anemia, mistype blood transfusion, even after intense exercise, urine can also be like soy sauce color. Sometimes the urine is brown after sleep, which is characteristic of paroxysmal nocturnal hemoglobinuria. If this kind of urination occurs after eating green broad beans, you should be alert to faba disease. The patient's red blood cells lack a substance called phosphoglucose dehydrogenase, which is somewhat heritable. Therefore, when eating broad beans, brown urine will appear, and fatigue, dizziness, nausea, skin, and yellow eyes should be sent to the hospital for treatment in case of any accident.

Colorless urine: may be a signal of diabetes, chronic interstitial nephritis, diabetes insipidus, if not drinking too much, should pay attention to identification.

White urine: White urine is common in purulent urine, chyluria, and salt urine.

Purulent urine: caused by severe urinary purulent infection, urine is milky white. Purulent urine is common in pyelonephritis, cystitis, renal abscess, urethritis, or severe renal tuberculosis. Chyluria is one of the main symptoms of filariasis, white urine like milk. Because the intestinal absorption of the chyle (the liquid after the saponification of fat) can not be drained from the normal lymphatics to the blood circulation, it can only flow back into the lymphatics of the urinary system, causing the lymphatic pressure in the urinary system to increase, varicose and rupture. The chyle is spilled into the urine, and chyluria appears. Chyluria is generally paroxysmal. When there are red blood cells in the chyluria, it is called chyluria. Microfilaments (ie, young silkworms) can sometimes be found in the blood and urine of patients with chyluria.

Salt-type urine: Most children are common in winter, and the urine is rice-like. Most of them contain a large amount of phosphate or uric acid in the original. It is easy to precipitate after being placed. If the urine is placed in the bottle, it will be immediately cleared. Salt urine is a normal physiological phenomenon. Can be cured without drugs, the key is to drink more boiled water.

Yellow urine: refers to urine that is yellow or dark yellow. The reasons are:

1 When eating carrots, taking riboflavin, , , rhubarb and other Chinese and Western medicines, the urine may turn yellow. Once you stop taking it, it will disappear and you don't have to worry about it. Common fever or vomiting and diarrhea patients are discharged with sweat or feces, urine will be concentrated and reduced, and urine pigments will not change, so the color of urine will appear very yellow.

2 Another type of urinary yellow like strong tea is not due to the above reasons, but the liver or sac has lesions. It turns out that there are usually two paths for bile to go out: one out of the urine and one out of the intestines. When the liver or gallbladder is sick, the path of bile to the intestine is cut off, it can only be discharged from the urine, and the urine is dark yellow due to the increase in bile content. In the early stages of hepatitis, jaundice has not yet appeared. We can often see the color of urination like strong tea, which is often a sign of hepatitis.

In addition, yellow turbid pyuria is a manifestation of urinary organ purulence.

Red urine: urine color turns red, mostly red blood cells in the urine, medically called hematuria. The cause of hematuria is very complicated. There are hundreds of diseases that can cause hematuria. It is not so easy to diagnose correctly.