A Colorful Conundrum: Dark Urine in a Patient With Inflammatory Bowel Disease



Question: A 42-year-old Caucasian woman, with a newly diagnosed Crohn’s colitis, A3L2B1 according to the Montreal classification, began treatment with 40 mg of Prednisone daily (scheduled for gradual tapering) and 2 g of Mesalamine daily. Two months later, she noticed dark urine in the toilet. She had no history of renal disease and no previous episodes of urine discoloration. Her medical history was significant for hypothyroidism and remote splenectomy after a car accident. The patient reported no abdominal and flank pain, dysuria, nausea, vomiting, diarrhea, fever, alcohol consumption, illicit drug use, allergies, trauma, or any recent travels.

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