Sirs,

I read with great interest the article entitled “Orange-colored diapers as first sign of Lesch–Nyhan disease in an asymptomatic infant” by Gasperini et al. that was recently published in Pediatric Nephrology [1].

These authors made the point that orange-colored diapers after the neonatal period may indicate early manifestation of Lesh–Nyhan disease and that in such cases a metabolic disorder should be excluded. I agree with the authors that the production of orange urine by infants is not always benign and report here the cases of three infants who presented at Jordan University Hospital with orange urine. The findings of the biochemical tests are shown in Table 1. Family history was positive for gout in all three infants, and stones were found in cases 1 and 3.

Table 1 Results of biochemical tests for three infants presenting with orange-colored urine
Full size table

While orange urine may simply be a reflection of benign increased urinary uric acid concentration, more ominous disorders must be ruled out. It may be associated with metabolic disorder and morbidity [2].

A careful diagnosis is warranted, especially in the presence of a positive family history of gout.