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During first hours of hospitalization, a purplish red coloration of the urine similar to Rioja wine was observed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). She had not previously reported episodes of altered urinary coloration. The patient had a history of hypertension, dyslipidemia, hypothyroidism and incipient Parkinson disease. Physical examination, laboratory data and vital signs were normal and she did not refer abdominal pain, dysuria, fever or other symptoms. Urinalysis showed indeterminate analytical interference without red blood cells so she was questioned about the consumption of illicit drugs, herbalism products or foods such as beetroot, blackberries or rhubarb. After reviewing the emergency history, the only previously administered treatment was 5<span class="elsevierStyleHsp" style=""></span>g of hydroxocobalamin, so it was concluded that the change in urinary coloration had been due to the administration of this drug. After 1 week, the urine had returned to its original color without specific treatment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The red coloration of the urine is usually due to the presence of red blood cells secondary to pathology in the urinary tract, so it must be ruled out by urinalysis. Likewise, a dark red coloration of the urine can be produced in situations of hemolysis. On the other hand, the presence of red-vinous urine has been described as a benign adverse effect of the administration of hydroxocobalamin. This drug is usually administered for cyanide poisoning that can occur during house fires due to the combustion of products that contain carbon and nitrogen, so treatment should be administered when suspected. It works by binding to cyanide to form cyanocobalamin and excreted in the urine. This adverse effect is resolved without treatment during the first week.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0020" class="elsevierStylePara elsevierViewall">This work has the informed consent of the patient.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 799 "Ancho" => 600 "Tamanyo" => 76467 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016000000012/v1_202306191131/S2387020623002164/v1_202306191131/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016000000012/v1_202306191131/S2387020623002164/v1_202306191131/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002164?idApp=UINPBA00004N" ]
Journal Information
Vol. 160. Issue 12.
Pages e21 (June 2023)
Vol. 160. Issue 12.
Pages e21 (June 2023)
Image in medicine
Red wine coloured urine
Orina color vino tinto
Ramón Baeza-Trinidad
, Luis Rosel-Rioja, Yasmina Brito-Diaz, Cristina Gay-Gonzalez
Corresponding author
Internal Medicine Department, Hospital San Pedro, Logroño, Spain
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