hemolysis

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hemolysis

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som
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08/30/06 - 07:42 AM

how do we differentiate extravascular frm intravascular hemolysis?

tolito
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08/30/06 - 08:07 AM

in Extrav, the haptoglobulin level is normal and there is mild unconj jaundice, may be splenomegaly

in Intrav, the haptoglobulin level is low, with high unconj bil.

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kickinit
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08/30/06 - 08:14 AM

INtravascular Hemolysis: -Hbnemima/Hbnuria -MetHbnemia/MetHburia -DECR.Haptoglobins/Hemopexin -INCR.Unconj Bilirubin Extravascular Hemolysis: -Spleen++ -Liver++ -Incr.Bilirubin -Decr.Haptoglobin but not as much as Intravascular Hemolysis. (NO Hbnemia, Hburia, MetHb )

kickinit
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08/30/06 - 08:22 AM

Intravascular Hemolysis :

-HBnemia/Hburia + MetHB/MetHBuria

-Decr. Haptoglobins/Hemopexin

-Incr. Unconjug.Bilirubin

Extravascular Hemolysis:

-Spleen+++/Liver +++

-Decr. Haptoglobins but not as much as Intravascular Hem.

-Incr. Unconjug. Bilirubin but not as much as Intrav.Hem.

-NO HBnemia/HBuria or MetHB

Sea_gull
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08/30/06 - 02:11 PM

kickinit wrote:
Intravascular Hemolysis :

-HBnemia/Hburia + MetHB/MetHBuria

-Decr. Haptoglobins/Hemopexin

-Incr. Unconjug.Bilirubin

Extravascular Hemolysis:

-Spleen+++/Liver +++

-Decr. Haptoglobins but not as much as Intravascular Hem.

-Incr. Unconjug. Bilirubin but not as much as Intrav.Hem.

-NO HBnemia/HBuria or MetHB

Are you sure that there is Methemoglobinemia and Methemglobinuria in intravascular hemolysis.Would you please explain and tell the source .
Thanks for co-operation.
GL

kickinit
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08/31/06 - 02:57 AM

Ok the Source is Kaplan Step 1, Pathology, RBC Chapter.

They dont really say why, But i think what happens is that when the haptoglobins have been saturated with Hb some of the free HB is oxidized to methb. And according to Davidson it may even be bound to albumin. So u might find Methemalbumin.

Umm.There doesnt seem to be much reference to Methb in other sources ..so i suppose you should count on stonger indicators like the decr. Haptoglobins , Hbnemia & Hburia.

peace.

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