Hemolytic anemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

• 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.
• The direct Coombs test is positive if hemolysis is caused by an immune process.
• Hemosiderin in the urine indicates chronic intravascular hemolysis. There is also urobilinogen in the urine.

(Images shown below are courtesy of Melih Aktan MD, Istanbul Medical Faculty - Turkey, and Hospital Universitario La Fe Servicio Hematologia)

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  Microangiopathic hemolytic anemia
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  Microangiopathic hemolytic anemia