- Immune reactions.
- Toxins and poisons.
- Treatments such as hemodialysis.
- Jaundice - usually mild.
- Chest pain.
- Leg cramps with exercise.
- Abdominal fullness and discomfort.
- Bilirubin level usually only mildly elevated (3 to 6 mg/dL) may be within normal range if mild.
- LDH elevated with hemolysis.
- CBC - evaluate for schistocytes and reticulocytes count; CBC usually increased; indicates increased erythropoiesis.
- Direct antiglobulin test (DAT, direct Coombs' test to detect the presence of IgG and complement (C3) on the RBCs; differentiates immune form non-immune hemolysis.
- LFTs and alkaline phosphatase usually within normal limits.
- Haptoglobin levels are decreased as protein binds hemoglobin.
- Urinalysis - elevated urobilinogen, even without hyperbilirubinemia.
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