investigations of haemolytic anaemia

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  • full blood count:
    • reticulocytosis - present if there is increased red cell production

  • blood film:
    • polychromasia, macrocytosis: increased red cell production
    • spherocytosis: hereditary spherocytosis
    • elliptocytosis: hereditary elliptocytosis
    • sickle cells

  • bilirubin - increased in unconjugated bilirubin if there is increased red cell destruction (also increased urinary urobilinogen and reduced haptoglobin)

  • LDH: increased if red cell destruction

  • urine:
    • urobilinogen: high if increased RBC destruction
    • haemoglobinuria, haemosiderinuria: present in intravascular causes of RBC destruction

Other tests:

  • Coomb's test - tests for autoimmune cause of haemolytic anaemia
  • Donath-Landsteiner antibody - if paroxysmal cold haemoglobinuria

Last reviewed 08/2021

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