The purpose of a hemolytic workup is to determine:

  • If hemolysis is indeed occurring
  • What the cause of it may be

This workup should be done on a blood sample that’s drawn before the patient receives a blood transfusion. Transfused blood can obfuscate the results of the workup and render the workup useless and non-diagnostic.

Components of an initial hemolytic workup

  • CBC with differential
  • Peripheral smear
  • Serum bilirubin
  • Haptoglobin
  • Fibrinogen
  • Lactate dehydrogenase (LDH)
  • Direct antibody (Coombs) test
  • Urinalysis