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논문분류	춘계학술대회 초록집
제목	Red-Brown Urine in a Patient With Ulcerative Colitis on Mesalamine: A Chemical Reaction With Sodium Hypochlorite
저자	Song Yi Kil
출판정보	2025; 2025(1):
키워드	Hematuria, Ulcerative Colitis, Mesalamine
초록	Gross hematuria, a major symptom of urinary tract diseases, can be caused by various factors. Inflammatory bowel disease (IBD) mainly involves the gastrointestinal tract, but it is also commonly associated with renal and urinary tract disorders. In particular, gross hematuria can occur in IBD patients with IgA nephropathy or urinary tract stones. Therefore, when an IBD patient presents with gross hematuria, a comprehensive evaluation of the urinary tract, including assessments for IgA nephropathy and urinary tract stones, should be conducted. However, in addition to pathological causes, patients taking mesalamine, a common treatment for IBD, may experience red-brown urine discoloration, which can be mistaken for hematuria. This discoloration results from a chemical reaction between mesalamine and sodium hypochlorite, a common component of toilet detergents. We report the case of a 27-year-old ulcerative colitis patient who had been taking mesalamine for four years. Nine months after starting the medication, she presented with gross hematuria accompanied by flank pain. Further evaluation suggested nutcracker syndrome, and she was monitored without specific treatment. She intermittently noticed red-brown urine even in the absence of abdominal pain and observed that it coincided with the use of toilet detergent. With keen awareness and close observation, she identified that the discoloration occurred specifically when her urine mixed with the toilet detergent. She reported this observation to her attending physician, who confirmed that mixing sodium hypochlorite with the urine caused a red-brown discoloration, similar to the color change observed when a mesalamine tablet was mixed with sodium hypochlorite. In IBD patients taking mesalamine who present with gross hematuria, it is advisable to consider the possibility of a chemical reaction with toilet detergent before proceeding with extensive diagnostic tests. This approach can help prevent unnecessary investigations and reduce patient anxiety.
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