Diagnostic Tests
Diagnosis of haemolytic anaemia usually involves a combination of medical history, physical examination, and laboratory tests. A complete blood count (CBC) and blood smear can be used to determine the presence of anaemia, as well as determine whether the anaemia is due to haemolysis. The CBC will also show an elevated reticulocyte count, which is an immature form of red blood cell. Other tests that may be used to diagnose haemolytic anaemia include a direct antiglobulin test (DAT), a direct Coombs test, and a complete red blood cell enzyme profile. In some cases, a bone marrow biopsy may be necessary.
Medical History
It is important to take a thorough medical history to help diagnose haemolytic anaemia. Questions may include family history of haemolytic anaemia, recent illnesses, medications, and exposure to toxins.
Physical Examination
During a physical examination, a doctor may look for signs and symptoms of anaemia, such as pale skin and fatigue. They may also look for signs of jaundice, which can be a sign of haemolytic anaemia.
Laboratory Tests
A CBC will measure the levels of red blood cells, haemoglobin, and haematocrit in the blood. It can also provide information about the size and shape of the red blood cells. A blood smear can be used to look at the red blood cells under a microscope. This can help determine if the red blood cells are abnormally shaped, which is often seen in haemolytic anaemia.
The DAT and direct Coombs test are used to determine if the red blood cells are being destroyed as a result of an autoimmune disorder. The DAT measures the presence of antibodies on the surface of the red blood cells. The direct Coombs test measures the presence of antibodies in the blood that are attacking the red blood cells.
The complete red blood cell enzyme profile is used to measure the activity of certain enzymes inside the red blood cells. These enzymes can be used to help determine the cause of the haemolysis.
A bone marrow biopsy may be necessary to determine the cause of the haemolysis. During a bone marrow biopsy, a sample of bone marrow is removed and examined under a microscope. This can help determine if there is an underlying cause of the haemolytic anaemia.