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What Causes Bright Yellow Urine With Kidney Pain When Diagnosed With Hepatosplenomegaly?

Posted on Wed, 25 Jan 2017

Question: So about 7 months ago I was diagnosed with hepatosplenomegaly. My spleen was mildly enlarged. I went to see a Gasto and he did a wide array of blood test from LFT's, to Anemia blood work, Iron blood work, Tumor marker blood work, protein blood work and much more. All my blood work was normal. I have also had LFT blood panel 4 months in a row after I was diagnosed and its all been normal so far. The Gastroenteroligist also did a exam after I had a CT scan 7 months ago and he told me it really didnt feel that enlarged but he could feel the tip of the spleen. He said lets wait 6 months and test again. I went in to see him for a 6 month follow up a couple weeks ago and he did another exam and said he can still feel the tip of my spleen a little but again the liver didnt feel enlarged. He ordered a ultra sound and more blood work (Which I have tomorrow). He told me that I most likely have a some fat build up in my liver but I shouldnt worry about it because all my blood work is normal. I also had blood work done by my normal doctor to test me for Anti-inflammatory diseases and Auto-immune diseases. All my blood work has been normal. I do have some mild pain in the upper region of the abdomen but he told me that its from the hydrocodone. I also had a endoscopy done by him 7 months ago for acid reflux and he said he didnt see any Varices (Whatever those are). I also have noticed that I have had some kidney pain in the morning the past couple weeks and my Urine is always brighter yellow. Not sure if that has anything to do with it but I thought I would share. What else could this be? And is this something I should be concerned about? The stress has been hard on me this past year.

Answered by Dr. Dr. Happykumar Kagathara (6 hours later)

Brief Answer:
follow up investigations to know progress/regress of condition

Detailed Answer:
Hello,
I can understand your worry on your abdominal finding on physical examination.
1) No, at present there is nothing serious with you.
2) Bright yellow urine with kidney pain suggest dehydration induced less urine formation by kidney. This might lead to stone formation in kidney. You must drink minimum 2.5-3 lit water per day.
3) Deposition of fat in liver tissue may cause enlargement of liver only, not the spleen. This problem might affect liver function only in severe case and this will be evident in blood report by high level of bilirubin and liver enzymes. Having normal liver function test indicates normal functioning liver.
4) Enlargement of spleen by feeling of just tip of it on palpation is not significant finding especially in background of all normal blood reports.
5) There is no need of repeat endoscopy for your symptoms or physical findings but you must do USG abdomen, liver function test, lipid profile test after 3 months again to evaluate progression or regression in findings.

Hope I answered your query. If you have any further doubts, I would be happy to help you.
Have a good day!

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Happykumar Kagathara (15 hours later)

So I had my Ultrasound this morning as well as all my blood work. Here is what I got back
WBC -- Normal (6.0)
RBC -- Normal (5.70)
Hemoblobin -- 17.8 (Range was 13.5 - 17.0 so Slightly elevated)
Hematocrit -- Normal (51.8)
MCV -- Normal (90.8)
MCH -- Normal ( 31.2)
MCHC -- Normal (34.4)
RDW -- Normal (12.2)
Platelet Count -- Normal (206)
Pt -- Normal (13.4)
INR -- Normal (1.04)
PTT -- Normal (28)
AFP Tumor Marker -- Normal (2.3)
AST/Sgot -- Normal (34) Test shows normal range is under 35
ALT/SGPT -- It says its in normal range but seems high to me. 70 was the number and it says standard range is under 78???
Alkaline Phosphatase -- Normal (36)

And the results of the Ultra sound
Liver is 17 CM -- Normal size
Spleen is Mildly enlarged measuring 13.6 cm
Kidneys are normal
They could not see the pancreas because of Gas in my sytstem
No masses of any kind

So Basically it appears everything is normal (Which is great news) minus the Slightly enlarged spleen.

So my questions are
Should I be concerned about the mildly enlarged spleen? What could be causing that if anything?
Should the slightly elevated Hemoglobin be a concern?
and lastly,the ALT at 70 seems high but it say its with in the normal range on the test. Should that number concern me?

Thanks

Answered by Dr. Dr. Happykumar Kagathara (7 hours later)

Brief Answer:
normal reports

Detailed Answer:
Hello,
I apologize for late reply.
1) All most all tests are within normal limit, only SGPT and SGOT are borderline elevated. This is not serious concern as far as USG abdomen eliminated fatty liver.
3) Spleen is not significantly enlarge. It also does not have any impact on RBC, WBC, platelet counts. You should not worry on this. I would recommend to do follow-up USG abdomen after 6 months for size of spleen and liver fat content.
4) For Hb value of 17.8 you should consult hemato-oncologist to find out cause for it, although it will not require any specific treatment (I apologize but your question on hemoglobin is not related to my speciality).

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng