Biochemical Signs of Hemolysis

Signs of intravascular hemolysis include:

1. Elevated lactate dehydrogenase (marker of tissue damage)
2. Reduction in haptoglobin (binds free hemoglobin [Hb])
3. UNnconjugated hyperbilirubinemia (byproduct of hemolysis)

*Be certain to check for increased reticulocytes ( bone marrow compensatory response) and blood smear (i.e Spherocytes, Schistocytes, Sickle cells)

REFERENCES

1. W. Barcellini and B. Fattizzo, “Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia,” Disease Markers, vol. 2015, Article ID 635670, 7 pages, 2015. doi:10.1155/2015/635670
2. Kato GJ, McGowan V, Machado RF, et al. Lactate dehydrogenase as a biomarker of hemolysis-associated nitric oxide resistance, priapism, leg ulceration, pulmonary hypertension, and death in patients with sickle cell disease. Blood. 2006;107(6):2279-2285. doi:10.1182/blood-2005-06-2373.