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False hematuria
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- Blood in the urine is detected both by the chemical reaction on a dipstick, and by observing red blood cells (RBC's) on microscopic examination of urine.
- Grossly red-colored urine, which can occur after certain ingestions, does not signify blood unless the dipstick is positive for blood (dipstick hematuria = DH) or RBC's are seen microscopically (microscopic hematuria=MH).
- DH and MH may occur after vigorous exercise, or after prolonged marches in military recruits. This is called "march hematuria" and is not a disease.
- Certain medications may harmlessly alter the enzyme reaction on the dipstick, causing the colorimetric reaction to occur which would indicate DH (even though there is none).
- A rare person might add a drop of blood to normal urine, seeking some type of gain (e.g., avoiding military service in wartime).
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- Grossly red urine, DH, or MH
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- March hematuria is diagnosed by the
absence of blood in first-morning urines, when the person
has not exercised.
- Generally, the diagnosis involves a
negative confirmatory test for blood. Also, gross hematuria
will generally turn from red to dark brown upon standing, due
to acid in the urine.
- A sample of red urine can be sent to a chemistry lab to
find the exact cause of the red color (if the red color is not blood). Sometimes the red color is caused by eating beets, or other harmless reasons for the red color
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- Confirmatory tests for DH or MH
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- This is distinguished from true hematuria.
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