Microangiopathic hemolytic anemia laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Mydah Sajid, MD[2]
Overview
Laboratory findings consistent with the diagnosis of microangiopathic hemolytic anemia include blood complete picture indicating hemolytic anemia, low platelet count and renal derangements. Specific tests like bacterial antigen detection, enzyme and antibody assays are done to diagnose underlying cause like hemolytic uremic syndrome and thrombotic thrombocytopenic purpura.
Laboratory Findings
Blood Tests
Laboratory findings consistent with the diagnosis of microangiopathic hemolytic anemia include[1]:
- Normochromic normocytic anemia
- Thrombocytopenia usually significant with platelet count less than 20,000/μL.
- High reticulocyte count
- Raised red ce distribution width
- Raised mean platelet volume
- Decreased haptoglobin levels
- Elevated unconjugated bilirubin level
- Elevated lactate dehydrogenase
- Red cell polychromasia, anisocytosis, and normochromic appearance with a lack of central pallor.
- As red blood cells travel through these damaged vessels, they are shredded. The result is red cell fragmentation and intravascular hemolysis. Under the microscope, damaged red cells have the appearance of schistocytes. It includes helmet cells, irregular projections, and crescent-shape[2][3].
- Automated analysers (the machines that perform routine full blood counts in most hospitals) are generally programmed to flag blood films that display red blood cell fragments or schistocytes.
- Raised urine urobilinogen level
- Elevated plasma creatinine level
- Proteinuria
- Hematuria
References
- ↑ Kottke-Marchant K (2017). "Diagnostic approach to microangiopathic hemolytic disorders". Int J Lab Hematol. 39 Suppl 1: 69–75. doi:10.1111/ijlh.12671. PMID 28447417.
- ↑ Zini G, d'Onofrio G, Briggs C, Erber W, Jou JM, Lee SH; et al. (2012). "ICSH recommendations for identification, diagnostic value, and quantitation of schistocytes". Int J Lab Hematol. 34 (2): 107–16. doi:10.1111/j.1751-553X.2011.01380.x. PMID 22081912.
- ↑ Lesesve JF, Speyer E, Perol JP (2015). "Fragmented red cells reference range for the Sysmex XN®-series of automated blood cell counters". Int J Lab Hematol. 37 (5): 583–7. doi:10.1111/ijlh.12364. PMID 25882632.