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The normal number of red blood cells in urine should not usually exceed 3 per high power field. [13] A urine test strip showing positive for blood can also indicate hemoglobinuria, which is not detectable using a microscope due to the lysis of red blood cells in the urinary tract (particularly in alkaline or dilute urine), or intravascular ...
Thus, a positive result for blood can represent the presence of red blood cells , free hemoglobin (hemoglobinuria), or myoglobin (myoglobinuria). [51] Red blood cells can sometimes be distinguished from free hemoglobin or myoglobin as the former causes a speckled pattern on the test pad while the latter results in a uniform color change.
In complicated or questionable cases, it may be useful to confirm the diagnosis via urinalysis, looking for the presence of urinary nitrites, white blood cells (leukocytes), or leukocyte esterase. [54] Another test, urine microscopy, looks for the presence of red blood cells, white blood cells, or bacteria.
Pyuria is the condition of urine containing white blood cells or pus. Defined as the presence of 6-10 or more neutrophils per high power field of unspun, voided mid-stream urine, it can be a sign of a bacterial urinary tract infection. Pyuria may be present in people with sepsis, or in older people with pneumonia.
A random urine, meaning a specimen that is collected at any time, can be used for many tests. However, a sample collected during the first urination of the morning (first morning specimen) is preferred for tests like urinalysis and pregnancy screening because it is typically more concentrated, making the test more sensitive .
An excess of white blood cells is usually due to infection or inflammation. Less commonly, a high white blood cell count could indicate certain blood cancers or bone marrow disorders. The number of leukocytes in the blood is often an indicator of disease, and thus the white blood cell count is an important subset of the complete blood count.
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The most common type of cast, hyaline casts are solidified Tamm–Horsfall mucoprotein secreted from the tubular epithelial cells of individual nephrons. Low urine flow, concentrated urine, or an acidic environment can contribute to the formation of hyaline casts, and as such, they may be seen in normal individuals in dehydration or vigorous exercise.