Hematoporphyrinuria

HEMATOPORPHYRINURIA (or hemoporphyrinuria), the appearance of a hematogenous (blood-derived) crystalline pigment (an isomer of bilirubin) in the urine, most commonly observed in poisoning with sulfonal, trional, tetronal, and similar substances, and sometimes in lead poisoning. Hematoporphyrin is a derivative of hematoporphyrin, artificially obtained by the action of sulfuric acid on hematoporphyrin and differing from it, among other things, by the absence of iron. Hematoporphyrin is a dark powder with a violet luster. In acidic solutions, hematoporphyrin gives one set of absorption bands, and in alkaline solutions, another. After taking sulfonal and its derivatives, the cherry-red coloration of the urine serves as a dangerous symptom. The reaction for hematoporphyrin in urine (Garrod reaction)—add caustic soda to the urine, filter, add absolute alcohol, dissolve the precipitate in hydrochloric acid, and determine two absorption bands using a spectroscope. It should also be borne in mind that when performing Betger and Nilander tests on urine for sugar, hematoporphyrin (like uroerythrin) may be captured by the precipitate, giving it a dark coloration, and thus causing an error. When hematoporphyrin is detected, stomach and rectal lavage should be performed, and laxatives, diuretics, and stimulants should be prescribed.