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October 3, 1977

More Causes of Red Urine

JAMA. 1977;238(14):1501. doi:10.1001/jama.1977.03280150071023

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To the Editor.—  "When the Urine is Red" (237:2753, 1977) is an extremely interesting and useful brief. It does, however, omit one class of "red urine" that I have observed.To simulate hematuria, some psychopathic or malingering patients have added not blood but other red substances to urine. Several whom I have observed have added ketchup or tomato juice, and this gave the urine a typical tomato odor. Isolation and identification of the red pigment of the tomato (lycopene, also found in watermelons) confirmed that ketchup or tomato juice had been added.