THE PARENTS of a 3-year-old boy sought consultation regarding a brownish
discoloration of their son's clothing and bed sheets noted after episodes of
enuresis. The parents report that the discoloration became more intense over
time. Their son had been healthy and without other complaints. There was no
history of illness or trauma. There were no urinary tract symptoms. The
medical history was unremarkable as was the family history.
There were no abnormal findings noted on the physical examination. Urine was
obtained for examination. The urine was clear and yellow in color with a
specific gravity of 1.010, pH of 6.5, and without evidence of hemoglobin,
myoglobin, red or white blood cells, or protein. A sample of the urine was
observed at room temperature for 48 hours with the color changes shown



What’s the Dx.?


Edward E. Rylander, M.D.
Diplomat American Board of Family Practice.
Diplomat American Board of Palliative Medicine.