A high urinary urobilinogen/serum total bilirubin ratio indicates acute hepatic porphyria in patients with abdominal pain.

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  • Author(s): Song C;Song C; Liu Y; Liu Y; Liu Y
  • Source:
    Scientific reports [Sci Rep] 2023 Dec 04; Vol. 13 (1), pp. 21330. Date of Electronic Publication: 2023 Dec 04.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : Nature Publishing Group, copyright 2011-
    • Subject Terms:
    • Abstract:
      Acute hepatic porphyria (AHP) has always been a diagnostic dilemma for physicians due to its variable symptoms. Correct diagnosis mainly depends on the detection of an elevated urinary porphobilinogen (PBG), which is not a routine test and highly relies on the physician's awareness of AHP. In the present study, we identified a more convenient indicator during routine examinations to improve the diagnosis of AHP. We found that AHP patients showed a significant higher "FALSE" urinary urobilinogen level caused by urinary PBG during the urinalysis when detected by strips impregnated with Ehrlich reagent (P < 0.05). And a remarkable increase in the urinary urobilinogen/serum total bilirubin ratio was observed in AHP patients. The area under the ROC curve of this ratio for AHP was 1.000 (95% confidence interval 1.000-1.000, P < 0.01). A cutoff value of 3.22 for this ratio yielded a sensitivity of 100% and a specificity of 100% to distinguish AHP patients from the controls. Thus, we proved that a "falsely" high urinary urobilinogen level that was adjusted by the serum total bilirubin level (urinary urobilinogen/serum total bilirubin ratio) could be used as a sensitive and specific screening marker for AHP in patients with abdominal pain.
      (© 2023. The Author(s).)
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    • Accession Number:
      14684-37-8 (Urobilinogen)
      RFM9X3LJ49 (Bilirubin)
    • Subject Terms:
      Porphyria, Acute Hepatic
    • Publication Date:
      Date Created: 20231203 Date Completed: 20231205 Latest Revision: 20231222
    • Publication Date:
      20231222
    • Accession Number:
      PMC10694128
    • Accession Number:
      10.1038/s41598-023-48824-9
    • Accession Number:
      38044386