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The Haemolytic Screen
Haemolysis is the destruction of red blood cells prior to the end of their normal 120-day lifespan, and should be considered in anaemic patients with risk factors or no obvious cause of anaemia. Serum markers may be used to diagnose haemolysis and suggest a cause.
Markers of Haemolysis
Haemoglobin
A marker of severity
M: 130 - 180
F: 115 - 165Bilirubin
Unconjugated hyperbilirubinaemia caused by haem metabolism
<1 mg/dL
<20 µmol/LHaptoglobin
Reduced haptoglobin due to binding of free haemoglobin
36 - 195 mg/dLLactate Dehydrogenase
Elevated isoenzymes LDH1 and LDH2 in haemolysis
120 - 280 U/LReticulocytes
Evidence of compensatory erythopoiesis
50-100x10⁹/L
0.5 - 2.5%Markers of Intravascular Haemolysis
Plasma free haemoglobin, urine haemoglobin, urine haemosiderin
Diagnosing Cause
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