Lab Case 86 – Interpretation

A 70 year old female presents unwell with compensated shock, pallor and shortness of breath

  1. Differential diagnosis:

Haemolytic anaemia

Infection – pneumonia, other

Cardiac failure – high output due to severe anaemia

Haemorrhage – upper GI bleed

2. Low Hb, high LDH, high Reticulocytes – severe anaemia with normal bone marrow function

high WCC, high neutrophil – Infection

High Urea, low Hb – Upper GI haemorrhage

3. Haptoglobin – low in haemolytic anaemia

Direct Coombs test – positive in autoimmune haemolytic anaemia (detects antibodies bound to red blood cells) (Indirect coombs test detects antibodies found in plasma – eg. Rhesus, blood group incompatibility)