Answer 3 Hemolytic anemia. The presence of dark urine, a sign of elevated conjugated bilirubin, indicates a hepatobiliary process, such as biliary obstruction, cirrhosis, or viral hepatitis. The lack of dark urine indicates elevated unconjugated bilirubin and thus points to a prehepatic process such as hemolytic anemia. This is because unconjugated bilirubin binds to albumin in the serum and is not filtered by the kidney. The patient most likely has hemolysis related to a mycoplasma infection. Click here to return to the questions

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