This could be a pH indicator type of reaction due to
food/medicine colouring additives, though it is odd to
change to blue on adding acid.
Mohammad
--- "dr. Dirk Bernard" <[log in to unmask]>
wrote: > Dear Colleagues,
>
> We received a urine from a patient admitted at
> midnight to the emergency ward forming a faint
> bleu-gray colour after adding
> TCA for total protein determination. The patient
> was admitted after being found in her home. She was
> found undercooled
> laying for several days on the ground with extended
> decubitus. The exact cause of her situation is not
> yet clarified.
> Known medications are venlafaxine, levomepromazin,
> risperidone, nordiazepam and alprazolam.
> On admission she received Duovent
> (fenoterolhydrobromide + ipratropiumbromide),
> gamma-globulins, tetanos vaccination and her
> standard medication continued.
> We received a urine sample for toxicological and
> biochemical screening 17 hours after admission.
> Screening for protein with dip-stick was posititive
> for protein and this urine produced a faint
> blue-gray colour
> after adding TCA for total protein. Micro-albumin
> (turbimetric) was 106 mg/L (positive).
> In this sample a very high concentration of
> venlafaxin and metabolites was found and a trace of
> levomepromazine.
> This contrasts with the (sub)-therapeutic
> concentration of venlafaxin found in her blood on
> admission.
>
> Can we attribute the faint blue-gray colour to
> levomepromazin or to venlafaxin?
> Any other suggestions?
>
>
> Dirk BERNARD, MD
> Clinical Chemistry-Toxicology
> AZ Sint Jan
> Ruddershove 10
> B-8000 Brugge
> België
>
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=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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------ACB discussion List Information--------
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