PMC8241095_01
Pink urine syndrome associated with propofol use during general anesthesia. (A) Pink urine in the urinary drainage bag and numerous pink substances on walls of the catheter. (B) Pink sediment rapidly precipitated in the urine following centrifugation.
fphar-12-686619-g001.jpg
PMC8241095_01_fphar-12-686619-g001.jpg
F1
The following morning, we observed pink urine in the urinary drainage bag and numerous pink crystals on the walls of the catheter (Figure 1A). A pink sediment rapidly precipitated in the urine following centrifugation (Figure 1B).
Urine sediment examination showing amorphous and colorless uric acid crystals under a polarizing microscope [(A) 200x; (B) 400x].
fphar-12-686619-g002.jpg
PMC8241095_01_fphar-12-686619-g002.jpg
F2
Under a polarizing microscope, amorphous, colorless UA-like crystals were identified (Figure 2).
Urinary uric acid levels during the perioperative period (-1: before surgery; 0: urinary drainage bag; 1-5: days after surgery). PUS: Pink Urine Syndrome.
fphar-12-686619-g003.jpg
PMC8241095_01_fphar-12-686619-g003.jpg
F3
We further examined the urinary UA concentration and the pH value and found that it was significantly increased in UA concentration (10,490 mumol L-1, lower than the real value due to UA precipitation on the catheter walls) and decreased in pH (5) (Figure 3). The concentration of UA in the patient's morning urine, 4 days post-operatively, was within normal limits (Figure 3).