A result pattern needs sorting

An EDTA CBC and serum chemistry specimen arrives, collected at 08:10. Hemoglobin is 86 g/L, reticulocytes are 8.1%, lactate dehydrogenase (LDH) is 815 U/L, total bilirubin is 42 micromol/L, and haptoglobin is less than 0.08 g/L. The serum is straw colored and has no analyzer hemolysis flag.

The question is not whether one result proves hemolysis. It is whether the integrated pattern supports increased red-cell destruction and where that process might be occurring. A hemolysis index or visibly pink serum alone can reflect collection or handling after the draw.

Start with specimen integrity, then assemble CBC, chemistry, urine, the direct antiglobulin test (DAT), and smear evidence. DAT detects immunoglobulin or complement coating red cells; it does not independently establish hemolysis or its cause. The pattern can support a mechanism family, but it cannot independently diagnose autoimmune hemolytic anemia, thrombotic microangiopathy, paroxysmal nocturnal hemoglobinuria, or enzyme deficiency. Release only results interpreted under the local specimen-integrity and interference procedure.