Leukocytes and Urobilinogen in Urine: What Your Test Results Mean

A urine dipstick test detecting leukocytes and/or urobilinogen can signal underlying conditions.

Leukocytes (White Blood Cells) in Urine

Normal: 0–5 WBC/hpf (microscopy) or negative on dipstick.

Positive dipstick (esterase) suggests:

• Urinary tract infection (UTI) – most common
• Kidney infection (pyelonephritis)
• Urethritis, prostatitis, vaginitis
• Contamination (improper collection)
• Interstitial nephritis, TB, stones, tumors (less common)

Urobilinogen in Urine

Normal: 0.2–1.0 mg/dL (or <17 µmol/L). Dipstick detects increased levels.

Elevated urobilinogen suggests:

• Hemolytic anemia (increased bilirubin production)
• Liver disease (hepatitis, cirrhosis – impaired uptake/conjugation)
• Gilbert's syndrome (benign reduced conjugation)
• Large hematoma resorption

Absent/low urobilinogen suggests:

• Biliary obstruction (stones, tumor)
• Broad-spectrum antibiotics (reduce gut flora that convert bilirubin → urobilinogen)

Next Steps

• Repeat test with clean-catch midstream urine.
• Microscopy and culture if leukocytes positive.
• Liver function tests (ALT, AST, bilirubin, ALP) if urobilinogen abnormal.
• CBC if hemolysis suspected.
• Clinical correlation is essential—dipstick is a screening tool, not diagnostic alone.

Always discuss results with your healthcare provider.