Patient's Query
Hi doctor,
I am a 29-year-old female who weighs 138 lbs, and I am 5.4 feet tall. For a year, I have been suffering from very strange symptoms like dark yellow urine (very deep yellow and sometimes turbid and cloudy in appearance), yellowish eyes, a very sour taste in the mouth throughout the day, increased heartbeat, and sudden sweating. A year ago, I had been having asthma and breathing difficulties for nearly five years, for which I had been taking an Asthalin inhaler and sometimes a nasal spray.
I was passing dark yellow urine throughout the day, in spite of drinking large amounts of water. I visited a general medicine doctor, and she checked my heartbeat and blood pressure, which were 145/94 mmHg. So, she put me on BP medication and also prescribed the antacid Nexpro for some days. I took an antacid and found temporary relief for ten days. After that, she told me to do all the body tests.
Kidney scan, ECG, X-ray, blood tests, etc., all reports were relatively normal. So, she told me to continue my medicine for BP. She said my symptoms could be the side effect of my asthma medication, and she asked me to stop the nasal spray and asthma medicine. So, I stopped the drugs five months ago.
Three months back, the problem of dark urine continued, and I did not visit any doctor, thinking that the problem would slowly go away. The doctor had told me not to worry. However, I have been waiting now for three months, and I still suffer the same symptoms. The symptoms are fewer now, but they are not completely gone. I visited a cardiologist, and he said that it is a metabolic or blood disorder.
Most probably hemoglobinuria or hemolytic anemia, and told me to meet another doctor. I went to a diabetologist; he asked me to do a liver function test, so I did it. Now the doctor is out of town, so I cannot visit him. I do not know which doctor to visit, and I am very confused, and my symptoms are not going away. My BP now stays at 130/85 mmHg after taking the BP medication. Could you please advise on what I need to do? I have attached all the test reports that I have done so far.
Kindly guide.
Thank you.
Hi,
Welcome to icliniq.com.
I have carefully gone through your reports (attachment removed to protect patient identity). Your case seems to be complicated.
In the case of yellow urine and yellow sclera with weakness, first, we should rule out hemolytic anemia and jaundice. Jaundice can be from hepatitis, cirrhosis, etc. But your serum bilirubin level is normal, so you do not have jaundice. And for hemolytic anemia, serum LDH (lactate dehydrogenase), reticulocyte count, and peripheral smear examination have to be done. If needed, hemoglobin electrophoresis can also be done.
As your urine is showing protein and globulin increase, kidney disease should be ruled out. Hypertension-induced renal nephropathy might be the reason. In the case of high globulin, plasma cell dyscrasia should also be ruled out. For that, an investigation with urine or serum protein electrophoresis and urine for Bence Jones protein can be done.
Macroglobulinemia and autoimmune problems sometimes lead to high globulin, so panel testing for autoimmune diseases can be done if needed. Your physical examination should be done to palpate the liver, spleen, and lymph nodes. If necessary, a CT (computerized tomography) scan and other higher investigations can be planned.
Sour taste in the mouth is from acid reflux or stress-induced gastritis, for which an antacid can be taken. If a kidney disease is strongly suspected, then a renal biopsy can be planned.
I hope my answer will help you.
Please feel free to reach out in case of further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you for the quick reply.
I will do all the tests that you suggested.
Thank you.
Hi,
Welcome back to icliniq.com.
As you have no further questions, I hope you got my suggestions.
For asthma, check your peak flow using a peak flow meter regularly. Palpitation could be from hypertension, also. And in young hypertension patients with proteinuria, it is better to use ACE (angiotensin-converting enzyme) inhibitor drugs like Enalapril, or ARB (angiotensin II receptor blockers) drugs like Telmisartan rather than calcium channel blockers.
I hope this helps.
Kindly revert so I can assist you further.
Thank you.
Patient's Query
Hello doctor,
Thank you for your suggestions.
Hi,
Welcome back to icliniq.com.
You are welcome.
If you have any queries, feel free to ask me.
Thank you.
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Answered byDr. Goswami Parth Rajendragiri
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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