Which clinical sign is associated with maple leaf toxicity?

• A. Hematuria
• B. Polyuria
• C. Lethargy
• D. Seizures

Answer: (A)

Maple leaf toxicity causes oxidative injury to red blood cells, leading to intravascular hemolysis. The damaged cells release hemoglobin, which is excreted in the urine, turning it dark brown to red. That change in urine appearance is what connects to the option describing blood in the urine, i.e., hematuria. While lethargy can occur and is nonspecific, and polyuria or seizures are not typical features, the hallmark clue is the urine color change due to hemoglobinuria from red blood cell destruction.