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Urinalysis test with positive KETONES, BLOOD and LEUCOCYTE ESTERASE.

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Hi I received a urinalysis test result with abnormal +2 ketones, +1 blood, 2+ leukocyte esterase, and above high normal 2+ WBC. No bacteria seen. This test was done at the same time as a fasting blood test. I did eat right before the urinalysis but after the blood work was taken. I had my period at the time but did try to clean the area best as possible before yielding the urine for the test. I have a history of UTIs but have no symptoms currently. This was a routine check up and I have had no other types symptoms either. What does this indicate? I do not have diabetes in my family and have not been diagnosed. Attached is the full report for blood work and urinalysis.

Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at DoctorSpring.com.
I understand your concern.I have gone through all your test results and they do not indicate anything abnormal with you.
- The positive ketones in urine are because of your fasting state. Fasting/starvation results in breakdown of fats and production of ketones which are excreted in urine. Eating right before the urinalysis would not affect the already present ketones in your urine.
- The blood as well as the positive RBCs are due to contamination with menstrual blood which is inevitable despite cleaning up.
- Above high normal WBCs in the absence of bacteria is known as sterile pyuria. In your case this could be due to contamination of the urine sample with vaginal leukocytes since you are menstruating. Leukocyte esterase test corresponds to pyuria, meaning it will be positive if WBCs are positive.
- The only other positive test you have is a reactive HBSAg Antibody test which is can be so if you have been vaccinated against Hepatitis B.
So in summary you do not have Diabetes or UTI or anything else for that matter.
I hope this was helpful. Feel free to ask queries.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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