Science of Urinalysis - Bilirubin Crystals

Science of Urinalysis - Bilirubin Crystals

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What are Bilirubin Crystals?

Bilirubin crystals appear in hepatobiliary diseases and are common in obstructive jaundice. Overall high levels of bilirubin indicate liver disease or poor liver function.

Bilirubin in fresh urine has a yellowish-brown color and foams easily. Bilirubin crystals are typically red-brown with needle-shaped projections that gather in a radial fashion. These crystals may resemble ammonium biurate crystals that are seen in alkaline urine, so the presence of bilirubin in the sample and accurate pH determination on the urine dipstick is important for correct identification.

Morphology/Features:

  • Acidic pH; dipstick positive for bilirubin
  • Needle-shaped, often seen in clumps, but may appear as spheres, cubes or granules
  • Yellow or red-brown in color; bilirubin will often stain cells, casts and other crystals in the sample


Resources:

https://www.kidney.org UF-Series Clinical Case Study Volume 2, Sysmex Corporation, Kobe, Japan.




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