Hemolytic Anemia - Diagnosis

Diagnosis

• Peripheral blood smear microscopy:
  • fragments of the red blood cells ("schistocytes") can be present
  • some red blood cells may appear smaller and rounder than usual (spherocytes)
  • Reticulocytes are present in elevated numbers. This may be overlooked if a special stain is not used.
• The level of unconjugated bilirubin in the blood is elevated. This may lead to jaundice.
• The level of lactate dehydrogenase (LDH) in the blood is elevated
• Haptoglobin levels are decreased
• If the direct Coombs test is positive, hemolysis is caused by an immune process.
• Hemosiderin in the urine indicates chronic intravascular hemolysis. There is also urobilinogen in the urine.