Tareq Abadl: Extravascular Hemolysis The High-Yield Guide
Tareq Abadl, Medical Lab Specialist, shared a post on LinkedIn:
“Extravascular Hemolysis
Where are the RBCs destroyed?
In extravascular hemolysis, RBCs are removed from circulation by macrophages, mainly in the spleen and liver.
What happens in the Lab?
- High Indirect Bilirubin
- Hemoglobin is broken down within macrophages, increasing bilirubin production.
- High Reticulocytes
- The bone marrow responds to increased RBC destruction by increasing RBC production.
- High LDH
- LDH may be elevated as a marker of hemolysis, but it is not specific for extravascular hemolysis.
- Low Haptoglobin
- Haptoglobin can decrease in hemolysis, but this finding occurs in both intravascular and extravascular hemolysis and should not be used alone to distinguish them.
Peripheral blood smear
Spherocytes may be seen, particularly in:
- Hereditary spherocytosis
- Warm autoimmune hemolytic anemia
Hemoglobinuria or Hemosiderinuria
These findings are more characteristic of intravascular hemolysis and are generally absent in typical extravascular hemolysis.
Common Examples
- Warm autoimmune hemolytic anemia
- Hereditary spherocytosis
- Hypersplenism
- Lab memory tip
Extravascular occurs in the spleen and liver
RBCs are broken down by macrophages, leading to heme breakdown and increased indirect bilirubin.
Remember:
Not every hemolysis marker tells you where the RBC was destroyed.
The mechanism plus peripheral smear plus urine findings should be interpreted together.”
Stay updated with Hemostasis Today.
-
Sep 4, 2026, 02:18Edgardo Alania: Edoxaban in Intracranial Haemorrhage Survivors with AF
-
Sep 3, 2026, 20:33Jennifer Weinstein: Happy to Share Our New Work on the Patient Experience in VWD at the NBDF Conference
-
Sep 3, 2026, 20:31Guillaume Courbon: New Publication on Erythroid-Produced FGF23 and Its Role in Anemia
-
Sep 3, 2026, 20:30Phuong Khanh Morrow: FDA Approval Marks an Important Step Forward for the PV Community
-
Sep 3, 2026, 20:29Sarah Robins: Happy to Share This Portrait Film I Voiced for the NNHHF
-
Sep 3, 2026, 20:27Mireille Muller: Europe Needs More Plasma Donors
-
Sep 3, 2026, 17:48Isabel Sá: Starting a New Chapter as a Clinical Scientist in Molecular Genetics and Haematology
-
Sep 3, 2026, 17:40Chiwoo Oh: AS01B Adjuvant and Long-Term Immune Reprogramming After Shingrix Vaccination
-
Sep 3, 2026, 17:35Key Developments in Transfusion Medicine and Biotherapies in 2025 – AABB