Possible Serological and Laboratory Presentations

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The page below is a sample from the LabCE course Immune Hemolytic Anemias. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Immune Hemolytic Anemias (online CE course)
Possible Serological and Laboratory Presentations

Destruction of red cells (hemolysis) may be intravascular (within blood vessels) or extravascular (outside of blood vessels). Complement causes intravascular hemolysis, which can lead to hemoglobinemia (free hemoglobin in the serum/plasma) and hemoglobinuria (free hemoglobin in the urine). Phagocytosis of red cells by macrophages facilitates extravascular hemolysis, which causes an increase in serum bilirubin.
Potential serological/laboratory findings encountered when immune-mediated anemia is present include:
  • Decreased hemoglobin and hematocrit
  • Spherocytosis
  • Reticulocytosis
  • Possible compensatory increase in nucleated red blood cells
  • Elevated bilirubin and lactate dehydrogenase (LD) levels
  • Decreased haptoglobin
  • Positive DAT due to IgG and/or complement sensitization
  • Positive antibody screen