ascorbic-acid and Hemoglobinuria

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Agranulocytosis; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Ascorbic Acid; Autoantibodies; Autoimmune Diseases; Blood Transfusion; Chloroquine; Colitis; Colitis, Ulcerative; Drug Hypersensitivity; Drug Therapy; Hemoglobinuria; Hemoglobinuria, Paroxysmal; Humans; Internal Medicine; Leukopenia; Lupus Erythematosus, Systemic; Neutrophils; Purpura; Purpura, Thrombocytopenic; Purpura, Thrombotic Thrombocytopenic; Splenectomy; Thrombocytopenia; Thyroiditis; Toxicology; Vitamins

Topics: Adult; Aged; Ascorbic Acid; Bilirubin; False Negative Reactions; False Positive Reactions; Female; Glycosuria; Hemoglobinuria; Humans; Male; Middle Aged; Nitrites; Retrospective Studies; Urinalysis; Young Adult

Vitamin C may interfere with the results of urine dipstick tests. We investigated the incidence of urinary vitamin C and its interference with urine dipstick reagents using a vitamin C dipstick.. The incidence of urinary vitamin C was determined in patients and healthy individuals undergoing routine medical check-ups. Interference tests were performed using samples with various amounts of added vitamin C. For clinical samples, we identified false-negative dipstick glucose, hemoglobin, and leukocyte esterase results based on the urine sediment and serum glucose results.. Vitamin C was found in the urine of 18.1% of the subjects overall, and 23.1% of those undergoing medical check-ups. Dipstick results for glucose, leukocyte esterase, and hemoglobin differed between samples without vitamin C and with added vitamin C. When vitamin C was detected in clinical urine samples, 42.3%, 10.6%, and 8.2% of the glucose, hemoglobin, and leukocyte esterase dipstick tests were rated as false negative, respectively.. Vitamin C was frequently found in clinical urine samples, and its concentration was higher in individuals undergoing medical check-ups. Urinary vitamin C can interfere with the urine dipstick results. This study gives useful information for predicting false-negative rates of urine dipstick tests caused by vitamin C.

Topics: Ascorbic Acid; Carboxylic Ester Hydrolases; False Negative Reactions; Glycosuria; Hemoglobinuria; Humans; Reproducibility of Results; Urinalysis

Naphthalene, a widely used industrial and household chemical, has rarely been an agent of poisoning worldwide. Severe haemolysis from naphthalene poisoning is rare and can be a challenge to clinicians. We report a 22-year-old female, who accidentally ingested naphthalene mixed coconut oil and got admitted with recurrent vomiting, headache and passage of dark urine. Severe intravascular haemolysis with hypotension and neutrophilic leukocytosis was detected. She was treated with red blood cell transfusions, intravenous saline infusion and ascorbic acid.

Topics: Administration, Oral; Anemia, Hemolytic; Ascorbic Acid; Coconut Oil; Erythrocyte Transfusion; Female; Glucose; Hemoglobinuria; Hemolysis; Humans; Hypotension; Infusions, Intravenous; Methemoglobinemia; Naphthalenes; Plant Oils; Poisoning; Severity of Illness Index; Treatment Outcome; Young Adult

Abstract Heme catabolism and iron sequestration systems play an important role in regulating the response to extracellular hemoglobin (Hb). We previously reported that extracellular Hb oxidizes more readily in the circulation of guinea pigs, a nonascorbate (AA)-producing species with similar plasma and tissue antioxidant status to humans, compared to rats, an AA-producing species. To determine whether these two species exhibit differences in heme catabolism and iron sequestration at the level of the kidney, we examined heme oxygenase (HO), H- and L-ferritin expression, nonheme iron deposition, and renal AA content following transfusion with polymerized bovine hemoglobin (HbG). Both species showed similar rates of hemoglobinuria but urinary HbG was significantly more oxidized in guinea pigs. HbG enhanced HO activity in both species but appeared greater and more sustained in guinea pigs. Conversely, rats showed a greater and more rapid induction of H- and L-ferritin as well as greater iron accumulation and AA content. Furthermore, ferrous and ferric iron deposits were detected in rats while only ferric iron was observed in guinea pigs. These findings suggest significant differences in the renal handling of HbG which may be important for understanding how endogenous antioxidant defenses may modulate the renal response to extracellular Hb.

Topics: Animals; Ascorbic Acid; Blood Component Transfusion; Blotting, Western; Cattle; Creatinine; Ferritins; Guinea Pigs; Heme Oxygenase (Decyclizing); Heme Oxygenase-1; Hemoglobins; Hemoglobinuria; Iron; Kidney; Male; Polymers; Rats; Rats, Sprague-Dawley; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

A method is described for estimating plasma and urinary hemoglobin concentrations as low as 3 mg/L. The assay measures at 528 nm the rate of peroxidation of chlorpromazine by hemoglobin and is not affected by ascorbate and bilirubin concentrations up to 500 mumol/L. Results by this method (mean +/- SD: 54.4 +/- 41.6 mg/L; n = 19) correlated well with those by a scanning spectrophotometric method (52.5 +/- 41.6 mg/L; r = 0.96) and a Coulter Instrument method (r = 0.99; Coulter method: 125 +/- 15 g/L; rate method: 122 +/- 15 g/L; n = 10, r = 0.99). The correlation for assays of 20 plasma samples by our method and a tetramethylbenzidine method was also good (r = 0.95) though the latter gave lower results (31.1 +/- 31.6 mg/L) than the chlorpromazine method (50.9 +/- 41.1 mg/L). The chlorpromazine rate method gave an intra- and interday CV of 7.9% and 9.7%, respectively, at a hemoglobin concentration of 31 mg/L.

Topics: Adult; Ascorbic Acid; Bilirubin; Chlorpromazine; Female; Hemoglobins; Hemoglobinuria; Humans; Hydrogen Peroxide; Kinetics; Male; Middle Aged; Phosphoric Acids; Reference Values; Spectrophotometry

Examination of 4379 routine urinalysis specimens with dipsticks sensitive to ascorbic acid showed that 22.8% were positive specimens. The mean urinary vitamin C concentration in this population was 2120 mumol/L. There was a high rate of false-negative dipstick results for hemoglobin in patients with vitamin C in the urine. The highest false-negative rates were observed in urine samples containing less than 50 erythrocytes per high-power field. In further experiments when volunteers consumed supplemental oral USP vitamin C at doses of 100, 250, 500, and 1000 mg or vitamin C-containing fruit juices, even the lowest doses of oral vitamin C or juice resulted in sufficient urinary vitamin C to produce false-negative dipstick results in hemoglobin and glucose testing. To prevent potentially dangerous false-negative results, screening urinalysis protocols relying only on dipstick testing should include a check for urinary vitamin C or use a dipstick that is not subject to vitamin C interference.

Topics: Ascorbic Acid; False Negative Reactions; Glycosuria; Hemoglobinuria; Humans; Reagent Strips; Urinalysis

Topics: Ascorbic Acid; False Positive Reactions; Glycosuria; Hemoglobinuria; Humans; Reagent Strips

Vitamin C (ascorbic acid), commonly taken as a dietary supplement and excreted in the urine, can interfere with peroxidase redox indicator systems such as those used in reagent-strip tests for urinary glucose and hemoglobin. We investigated whether the concentrations of ascorbic acid in urine after modest supplementary doses of vitamin C are high enough to interfere with such dipstick tests. After adding glucose or hemoglobin to urine collected from persons not taking vitamin C and from persons taking 350 to 1000 mg of vitamin C daily, we tested four reagent strips for interference and found that these commonly taken doses did frequently interfere with all test systems examined.

Topics: Ascorbic Acid; False Negative Reactions; False Positive Reactions; Glycosuria; Hemoglobinuria; Humans; Indicators and Reagents; Reagent Strips

Results for urinary glucose by the Boehringer Mannheim BM33071 test pad and a hexokinase-based method agree well. The new test, which involves the glucose oxidase/peroxidase reaction, measures as little as 260 mg of glucose per liter. Acetoacetate, beta-hydroxybutyrate, and human hemoglobin do not interfere.

Topics: 3-Hydroxybutyric Acid; Acetoacetates; Ascorbic Acid; Evaluation Studies as Topic; Glucosephosphate Dehydrogenase; Glycosuria; Hemoglobinuria; Hexokinase; Humans; Hydroxybutyrates; Indicators and Reagents; Reagent Strips

Topics: Acid-Base Equilibrium; Albuminuria; Ascorbic Acid; Bence Jones Protein; Bile Pigments; Bilirubin; Color; Drug Antagonism; Hematuria; Hemoglobinuria; Humans; Indicators and Reagents; Ketone Bodies; Paper; Peroxidases; Phenolphthaleins; Phenols; Povidone; Proteinuria

Topics: Alginates; Aniline Compounds; Ascorbic Acid; Biphenyl Compounds; Chemistry, Clinical; Chromatography, Gel; Hemoglobinuria; Indicators and Reagents; Methods; Peroxidases; Uric Acid