All are features of Intravascular hemolysis except -
High-Yield Explanation
Hemolytic anemia
Hemolytic anemia is anemia due to hemolysis, i.e. the abnormal breakdown of red blood cells.
Hemolytic anemia has the following features -
A shortened red cell lifespan, i.e. premature destruction of red cells.
Elevated erythropoietin level and increased erythropoiesis in the marrow and other sites, to compensate for the loss of red cells→ characterized by increased reticulocyte count.
Accumulation of the products of hemoglobin catabolism due to an increased rate of red cell destruction.
Hemolysis may occur either inside the blood vessels (intravascular hemolysis) or within the mononuclear phagocytic system of spleen, liver or bone marrow (extravascular hemolysis).
Intravascular hemolysis
Due to the destruction of RBC, hemoglobin is released into blood → Hemoglobinemia.
Excess of hemoglobin may be excreted by kidney → hemoglobinuria.
Some of the hemoglobin is reabsorbed in kidney and is converted to hemosiderin which is then excreted → hemosiderinuria.
Free hemoglobin in plasma bound to haptoglobin and this complex is rapidly cleared by mononuclear phagocytic system Decreased haptoglobin.
When haptoglobin is depleted, free hemoglobin is oxidized to methemoglobin → methemoglobinemia.
Excess heme groups are catabolized to bilirubin within the mononuclear phagocytic system → Increased indirect bilirubin and jaundice.
LDH is stored in the blood. During hemolysis this enzyme is released in the blood → Increased serum LDH.