An Individual with Jaundice Reports to the Emergency Department with Symptoms

An individual with jaundice reports to the emergency department with symptoms of an acute porphyric attack,including severe abdominal pain,pain in her thighs,vomiting,and muscle weakness.A hepatitis screen is negative and unconjugated bilirubin and urobilinogen are increased.Your laboratory receives a dark orange-colored urine sample for qualitative PBG analysis,results of which are difficult to interpret.When you contact the physician with this information,the physician informs you that this patient is an alcohol abuser and asks you to run a quantitative urine porphyrin analysis.Results of this analysis show an increased uroporphyrin and coproporphyrin III.Why was the PBG difficult to interpret?

A) In individuals with congenital erythrocytic porphyria,PBG is negative.
B) There was interference from elevated urobilinogen in the urine sample.
C) PBG only demonstrates an increase in fecal samples,not in urine.
D) Alcohol in the urine sample produced a false-negative value for PBG.