8.29.2007

Glow-In-The-Dark Pee

R the nurse was walking down the hall with an open urine cup, looking at it and smelling it. That doesn't happen too often. It looked like it was glowing; Mountain Dew straight out.

"You should put that under a Woods lamp (a black light)", I said. So we did, and gosh darn if it didn't glow like a kid's glowstick at Disneyland.

So what's the guy's story? He was an ingestion, unclear history, suicide attempt for two days...perhaps he decided to add antifreeze to his list. Antifreeze has a compound called fluorescein added for this exact reason, because antifreeze kills kidneys, tastes sweet, and tends to get ingested by kids and dogs. And alcoholics.
His blood alcohol level came back at an impressive 0.390, which is a personal best for me; this, actually, was really good news. Antifreeze is fun for two reasons--one for the fluorescent pee, two because the old school antidote is a lot of alcohol. The two are metabolized by the same pathway, but alcohol is a better substrate, so if you drink enough, you can prevent the antifreeze from being changed into it's toxic metabolite.

As with anything that's 'interesting', the guy's antifreeze level came back very low. Possible we just missed it and he had peed it all out. But, a Google search also turned up a wide variety of things that turn your pee fluorescent. In fact, there was an article in a pediatric journal that discussed a random sample of 30 pediatric urine tests, 21 of which were fluorescent underneath a Woods lamp. None of those patients had antifreeze poisoning.

Turns out niacin and other B vitamins turn your pee fluorescent, among other things, including certain other medications. I also wonder about food coloring, especially in children (perhaps why 21 of 30 randomly selected had fluorescent pee--have you seen what they eat?)

So the next time your friend drinks a pint of antifreeze, take him or her under a black light and hand them a fifth of tequila. And, again I'm reminded, even the classic cases, aren't.

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