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Haemolytic Screen
 
 

Intravascular Haemolysis

 
 
 
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Overview

  • Markers of Intravascular Haemolysis

  • Elevated plasma free haemoglobin
  • Elevated urine haemoglobin - urine dipstick positive for blood but no RBC
  • Elevated urine haemosiderin - brownish urine due to excess iron stored as haemosiderin
  • Causes of Intravascular Haemolysis

  • Microangiopathic haemolytic anaemia - TTP, HUS, DIC, preeclampsia / HELLP, SLE, malignant hypertension, severe burns, brown snake bite
  • Intravascular trauma - valvular leaks, cardiac prostheses, renal replacement, ECMO, march haemoglobinuria
  • Alloimmune haemolysis - transfusion of mismatched red blood cells, haemolytic disease of the newborn, post stem cell transplant
  • Infection - severe malaria, Clostridium toxin
  • Copper (Wilson’s disease)
  • Certain cold agglutinin haemolysis disorders
  • Paroxysmal nocturnal haemoglobinuria
  • G6PD deficiency
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