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Leukocyte Esterase
It is used in the screening of urine culture specimens
a more standardized means for the detection of leukocytes
detects lysed leukocytes in alkaline urine
120 seconds
REAGENT STRIP: LEUKOCYTE ESTERASE
reaction time
Action of Leukocyte Esterase to catalyze the hydrolysis of acid ester
REAGENT STRIP: LEUKOCYTE ESTERASE
Principle [Strasinger]
Action of Leukocyte Esterase to cleave an ester and form an aromatic compound followed by an azo coupling reaction of the aromatic amine formed with a diazonium salt on the reagent pad. color produced from beige to violet
REAGENT STRIP: LEUKOCYTE ESTERASE
Principle [Brunzel]
Violet (Purple)
REAGENT STRIP: LEUKOCYTE ESTERASE
Color
derivatized pyrrole amino acid ester, diazonium salt
REAGENT STRIP: LEUKOCYTE ESTERASE
Reagents [Multistix]
indoxylcarbonic acid ester, diazonium salt
REAGENT STRIP: LEUKOCYTE ESTERASE
Reagents [Chemstrip]
5 - 15 WBCs/HPF (~11-36 WBCs/uL)
REAGENT STRIP: LEUKOCYTE ESTERASE
Sensitivity [Multistix]
10-25 WBCs/HPF (~10 WBCs/uL)
REAGENT STRIP: LEUKOCYTE ESTERASE
Sensitivity [Chemstrip]
Highly pigmented urine (phenazopyridine, nitrofuratonin)
Formalin
Strong oxidizing agents
REAGENT STRIP: LEUKOCYTE ESTERASE
False (+)
High SG
Strong oxidizing agents
Increased glucose (>3g/dL) or Protein (>500 mg/dL), High Conc. Ascorbic Acid
Gentamicin, Cephalosporin, Tetracycline
REAGENT STRIP: LEUKOCYTE ESTERASE
False (-)
Should be repeated on new specimen
REAGENT STRIP: LEUKOCYTE ESTERASE
Reporting: Trace
Small
REAGENT STRIP: LEUKOCYTE ESTERASE
Reporting: 1+
Moderate
REAGENT STRIP: LEUKOCYTE ESTERASE
Reporting: 2+
Large
REAGENT STRIP: LEUKOCYTE ESTERASE
Reporting: 3+
Oxalic acid
REAGENT STRIP: LEUKOCYTE ESTERASE
__ does not affect leukocyte esterase because it does not exist in urine with a pH greater than 4.5
False negative
REAGENT STRIP: LEUKOCYTE ESTERASE
But in Strasinger 7th Ed, Oxalic acid is considered ____
Lymphocyte
REAGENT STRIP: LEUKOCYTE ESTERASE
WBC with no Esterase
Neutrophil, Eosinophil, Basophil, Monocyte, Histiocyte, Trichomonas
REAGENT STRIP: LEUKOCYTE ESTERASE
With esterase