Urobilinogen

Overview

Urobilinogen measures colorless tetrapyrrole compound formed in the distal gut by bacterial reduction of bilirubin and partially reabsorbed into portal circulation for hepatic re-excretion. It serves as a marker of hepatic bilirubin metabolism and enterohepatic circulation integrity. Elevated urinary levels indicate hepatic dysfunction, hemolytic disorders, or biliary obstruction, while absent levels suggest complete biliary obstruction; clinically useful for screening hepatobiliary disease, differentiating conjugated from unconjugated hyperbilirubinemia, and evaluating liver synthetic function.

Clinical Use Cases

  • Screening for hepatocellular disease and cholestasis.
  • Evaluating hemolytic anemia with increased bilirubin load.
  • Differentiating obstructive jaundice from hepatocellular jaundice.
  • Monitoring liver transplant function.
  • Assessing drug-induced hepatotoxicity.

Specimen Types

  • Random urine.
  • 24-hour urine collection.

Measurement Methods

  • Dipstick Ehrlich reaction (p-dimethylaminobenzaldehyde).
  • Watson-Schwartz qualitative test.
  • Spectrophotometric quantification.

Test Preparation and Influencing Factors

  • Avoid antibiotics (alter gut flora reducing urobilinogen).
  • Recent barium studies interfere with dipstick.
  • Exposure to light degrades samples.
  • Sulfonamides, methyldopa cause false-positive Ehrlich reaction.
  • Collect midstream clean-catch urine.

Synonyms

  • URO.
  • Urine urobilinogen.

Further Reading

  • “Urobilinogen in Urine” – MedlinePlus –