Hemoglobinuria is a condition in which the oxygen transport protein hemoglobin is found in abnormally high concentrations in the urine. The condition is caused by excessive intravascular hemolysis, in which large numbers of red blood cells (RBCs) are destroyed, thereby releasing free hemoglobin into the plasma. Excess hemoglobin is filtered by the kidneys, which excrete it into the urine, giving urine a purple color. Hemoglobinuria can lead to acute tubular necrosis which is an uncommon cause of a death of uni-traumatic patients recovering in the ICU. Causes
Acute glomerulonephritis
Burns
Renal cancer
Malaria
Paroxysmal nocturnal hemoglobinuria
Microangiopathies, e.g. hemolytic-uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP) leading to microangiopathic hemolytic anemia
Transfusion reactions
IgM autoimmune hemolytic anemia
Glucose-6-phosphate dehydrogenase deficiency
Pyelonephritis
Sickle cell anemia
Tuberculosis of the urinary tract
March hemoglobinuria secondary to repetitive impacts on the body, usually the feet
Athletic nephritis secondary to strenuous exercise
Acute lead poisoning

Diagnosis
The diagnosis is often made based on the medical history, blood samples, and a urine sample. The absence of urine RBCs and RBC casts microscopically despite a positive dipstick test suggests hemoglobinuria or myoglobinuria. The medical term for RBCs in the urine is hematuria. See also
Hematuria

References


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Trichobacteriosis axillaris is a superficial bacterial colonization of the hair shafts in sweat gland–bearing areas, such as the armpits and the groin. It is a trivial disease of worldwide occurrence that is believed to be caused by the genus Corynebacteria.The condition has been called extensively trichomycosis axillaris in the literature, but because it is a bacterial infection and not a fungal infection, it should be called trichobacteriosis. Presentation
It is characterized by the presence of concretions along the hair shafts, clinically observed as yellow, and rarely as red or black nodules. These concretions derive from bacterial colonization along the hair shaft containing dried apocrine sweat with a cementing substance generated by the bacteria. Cause
It is caused by several species of Corynebacterium.Obesity, hyperhidrosis, poor local hygiene, and warm, moist environments are common predisposing factors. Diagnosis
The infection is diagnosed by close examination of the hair shafts where brown to yellow material called concretions are seen. There is usually an associated rancid odour. A microscopic examination can confirm the diagnosis, but this is rarely needed.Some patients with excessive sweating present the so-called corynebacterial triad, that is, the simultaneous presence of trichobacteriosis axillaris, erythrasma, and pitted keratolysis. Treatment
No specific therapeutic studies on trichobacteriosis are available.Many authors consider that the most effective treatment consist in shaving of the affected area for a period of 2–3 weeks. The use of a concomitant treatment, such as sulfur soaps or benzoyl peroxide is also recommended.