Brief Answer:
Very likely XXXXXXX has G6PDH deficiency triggered by sulfa drugs- details below

Detailed Answer:
Hello and welcome to 'Ask A Doctor' service,

Jaundice with low hemoglobin is not due to liver disfunction but due to hemolysis. This means that the patient is having hemolysis which is exhausting the capacity of the liver and causing jaundice. Thus, liver disfunction would justify jaundice but not the fall in the hemoglobin level, there should be hemolysis to justify both jaundice and reduced hemoglobin.

I would consider G6PDH deficiency as the cause as he is taking sulfa drugs for pneumonia. My answers would be:

What is causing decreased hemoglobin: hemolysis probably due to G6PDH triggered by a sulfa drug

Is there a genetic relation? Yes. G6PDH is an X-linked recessive disorder (affects primarily males)

Should he be concerned regarding the color of his urine? Yes, it is an indication of hemolysis.
Diagnosis and the cause: very likely it is hemolysis due to G6PDH deficiency triggered by sulfa drugs.

I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.

Kind regards,
Dr. Antoneta Zotaj,
General and Family Physician

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Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

In a case like XXXXXXX hemolysis and presence of hemoglobin break down products is the onllmost likely cause of red urine. Liver conditions cause dark brown urine, not red urine.

The question in the paper is what are other possible causes of a red urine in general. In general, causes of red urine are:
- blood in urine due to infection, stones, tumors, etc
- nephritic syndrome in some cases of glomerulonephritis
- hemoglobinuria due to rabdomyolysis
- certain food (beetroots, food color in candies, etc)
- medications may cause change in urine color (these mostly cause dark brown urine, not exactly red).

I hope this answers your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj, General and Family Physician

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