What is the significance of bile in the urine of a patient with infectious mononucleosis?

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It is of limited clinical significance. Bile is a breakdown product of blood cells. It is filtered by the liver. Excess amounts of bile in the urine is generally a result of high blood levels from liver injury or excessive red blood cell lysis. In infectious mononucleosis, this finding does not affect your treatment plan nor the prognosis.

Bile contains bile salts, fatty acids, cholesterol, bilirubin, and other compounds.There are many causes of bilirubin in urine: 

Blockage of bile ducts due to gall stones;


Decreased conjugation. 

You'd better go to see a gastroenterologist for further check.