title: Mass spectrometry analysis of urine and catheter of a patient with purple urinary bag syndrome.
abstract: BACKGROUND
  Purple urinary bag syndrome (PUBS) is considered to be a benign condition observed in the urinary catheter and bag in some catheterized patients with urinary tract infections. This syndrome is usually reported to occur in alkaline urine.
  
  
  METHODS
  We report of a catheterized patient with PUBS and slightly acidic urine (pH 6-6.5). A novel analysis method was developed using high pressure liquid chromatography and mass spectrometry (HPLC/MS) to detect compounds that are thought to be associated with PUBS. Urine, urinary sediment, and the plastic collection system were assayed and quantitated using these methods. The potential toxicity of one of these compounds, indoxyl sulfate, is discussed.
  
  
  CONCLUSIONS
  The presence of PUBS in a catheterized patient with slightly acidic urine is reported. A novel method for the analysis of chemical components of PUBS and the first direct confirmation of the presence of indigo in the urine sediment and collecting system are described.
authors.affiliation: Swedish Medical Center, Trauma Research Laboratory, Englewood, CO 80113, USA. dbaror@dmibio.com
authors.forename: David
authors.initials: D
authors.lastname: Bar-Or
authors.forename: Leonard T
authors.initials: LT
authors.lastname: Rael
authors.forename: Raphael
authors.initials: R
authors.lastname: Bar-Or
authors.forename: Michael L
authors.initials: ML
authors.lastname: Craun
authors.forename: Jessica
authors.initials: J
authors.lastname: Statz
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Garrett
mesh_terms: D000368:Aged; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007200:Indican / Q000652:urine*; D007203:Indigo Carmine; D007211:Indoles / Q000652:urine; D013058:Mass Spectrometry; D013577:Syndrome; D014364:Tryptophan / Q000378:metabolism*; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000652:urine*
chemical_list: D007211:Indoles; D014364:Tryptophan; D007203:Indigo Carmine; D007200:Indican