Hemolytic anemia is characterised by features due to increased Hemolysis that is reduced RRC
life span and features due to Erythropoetic response of the bone marrow
Features due to Increased Hemolysis -Reduced RRC life span
- Hemoglobin: reduced
- Increase in unconjugated bilirubin
- Elevated LDH
- Increased AST
- Reduced Haptoglobin
- Increased Urobilinogen in urine (& stool)
- Increased Stercobilinogen in stool
- Hemoglobinuria (intravasculae hemolysis)
Features due to Ervthropoetic response of the bone marrow
- Increase in Reticulocytes (Reticulocytosis)
- Increase in MCV/MCH this is due to the increased number of reticulocytes
- Peripheral smear - Macrocytes, Polychromasia & sometimes nucleated red cells in smear. Routine bloodfilm shows a varietyt of abnormal morphological type of red cells such as Schistocytes ,Spherocytes etc.
- Bone narrow shows erythroid hyperplasia( Myeloid: Erythroid Ratio is decreased)with raised iron stores.
- X Rays of bones show evidence of expansion of marrow space, especially in tabular bones & in skull rsulting in bossing of skull
