False-Positive and False-Negative Blood Results

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The page below is a sample from the LabCE course Chemical Screening of Urine by Reagent Strip. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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False-Positive and False-Negative Blood Results

A false positive result for blood on the urine reagent strip can occur if the collection container or reagent strip is contaminated with oxidizing agents, such as hypochlorite (bleach), or if the specimen is contaminated with povidone-iodine, a strong oxidizing agent used in surgical procedures. Microbial peroxide associated with urinary tract infections may also cause false positive results.
The muscle tissue form of hemoglobin (myoglobin) is a well-known cause of false positive blood reactions on the reagent strip. When tissue hemoglobin is present, the urine specimen has a clear red appearance. Patients suffering from muscle-wasting disorders or muscular destruction due to trauma, prolonged coma, convulsions, or individuals engaging in extensive exertion may have myoglobin in their urine. Specific tests for myoglobin, such as immunodiffusion techniques or protein electrophoresis, are needed to confirm the presence of this substance in a urine specimen.
Captopril, formalin, high specific gravity, and a high concentration of ascorbic acid and nitrite can cause a false negative test result.
If the urine specimen is not mixed before testing, blood cells may settle in the sediment and produce a false negative result for blood.