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Leukocyte esterase (LE) is an esterase (a type of enzyme) produced by leukocytes (white blood cells). A leukocyte esterase test (LE test) is a urine test for the presence of white blood cells and other abnormalities associated with infection. White blood cells in the urine can indicate a urinary tract infection (UTI). Positive test results may ...
In the elderly, the leukocyte esterase test is often positive even in the absence of an infection. [citation needed] The urine dipstick test is readily available and provides fast, but often unreliable results. Some organisms such as chlamydia and Ureaplasma urealyticum will produce a negative leukocyte esterase reaction.
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.
Leukocyte esterase, an enzyme found in granulocytes, is measured to estimate the concentration of white blood cells. [53] The action of the enzyme on chemicals in the test pad ends in the creation of a purple azo dye . [ 54 ]
The urine test strip test for white blood cells detects leukocyte esterase, which is present in azurophilic granules of monocytes and granulocytes (neutrophilic, eosinophilic and basophilic). Bacteria, lymphocytes and epithelial cells from the genitourinary tract do not contain esterases. [21]
It has been arbitrarily assumed that a number of over 4-5 leukocytes in the field of vision of the microscope indicates leukocyturia. [ 4 ] At the moment, there are also quick test strips available, allowing after wetting a special diagnostic bar, the detection of granulocytes in the urine, as evidenced by the color change of the test strip. [ 5 ]
Also, urine dipstick showing leukocytes as equal predictive value as the presence of nitrites. When both are present, the predictive value goes even higher. If the patient only has leukocyte esterase or bacteria in the urine, then dysuria may suggest that the patient probably has urethritis. [3]
Isosthenuria may be seen in disease states as chronic kidney disease and acute kidney injury in which the kidneys lack the ability to concentrate or dilute the urine and so the initial filtrate of the blood remains unchanged despite the need to conserve or excrete water based on the body's hydration status.