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Cracking the Code: How Doctors Diagnose Hemolytic Anemia
Published: May 11, 2024
Diagnosing hemolytic anemia is like solving a medical mystery. Doctors use a combination of symptoms, physical exams, and laboratory tests to crack the case.
The Initial Clues
The diagnostic journey often begins with a complete blood count (CBC). This test measures various components of your blood, including red blood cell count, hemoglobin, and hematocrit. In hemolytic anemia, these values are typically low. The CBC also checks for an increased number of young red blood cells called reticulocytes, which can indicate your body is trying to compensate for the destruction of red blood cells.
Piecing Together the Evidence
Doctors often look for signs of red blood cell destruction. This includes checking levels of lactate dehydrogenase (LDH), an enzyme released when cells are damaged, and bilirubin, a yellowish substance produced when red blood cells break down. They also measure haptoglobin, a protein that binds to free hemoglobin in the blood. Low haptoglobin levels can indicate hemolysis.
Specialized Tests
To determine the specific type of hemolytic anemia, more specialized tests may be needed. The Coombs test checks for antibodies attacking red blood cells, which occurs in autoimmune hemolytic anemia. Genetic tests can identify inherited forms of the condition. Sometimes, a bone marrow biopsy might be necessary to rule out other blood disorders.
Visual Clues
Examining blood under a microscope can provide valuable information. Doctors look for abnormally shaped red blood cells, which can indicate specific types of hemolytic anemia. For example, sickle-shaped cells suggest sickle cell disease, while spherical cells might point to hereditary spherocytosis.
Frequently Asked Questions
Most tests involve simple blood draws with minimal discomfort.
It can range from a few days to weeks, depending on required tests.
Yes, which is why thorough testing is important.
Most are, but check with your provider for specifics.
Some tests may require fasting; your doctor will advise you.
Solving the Puzzle
While diagnosing hemolytic anemia can be complex, these tests help doctors pinpoint the cause and guide treatment.
References
- Barcellini W, Fattizzo B. Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia. Dis Markers 2015; 2015:635670.
- Brodsky RA. Warm Autoimmune Hemolytic Anemia. N Engl J Med 2019; 381:647.
- Fattizzo B, Barcellini W. Autoimmune Hemolytic Anemia: Diagnosis and Classification. Autoimmun Rev 2020; 19:102460.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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