What are the hematologic (hematology) examinations for hemolytic (hemolysis) anemia?

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From the Guidelines

Pemeriksaan hematologi untuk anemia hemolitik harus dimulai dengan hitung darah lengkap (CBC) dengan apusan darah perifer, hitung retikulosit, tes Coombs langsung dan tidak langsung, kadar bilirubin serum, laktat dehidrogenase (LDH), haptoglobin, dan elektroforesis hemoglobin. Pemeriksaan ini membantu menentukan penyebab, tingkat keparahan, dan pengelolaan anemia hemolitik yang tepat. Beberapa pemeriksaan tambahan yang dapat dilakukan termasuk:

  • Tes osmotic fragility untuk hereditary spherocytosis
  • Tes enzim G6PD
  • Tes piruvat kinase
  • Flow cytometry untuk paroksismal nokturnal hemoglobinuria Pemeriksaan-pemeriksaan ini harus dilakukan berdasarkan gejala dan riwayat pasien, serta hasil pemeriksaan awal 1. Perlu diingat bahwa anemia hemolitik dapat disebabkan oleh berbagai faktor, sehingga pemeriksaan yang tepat dan komprehensif sangat penting untuk menentukan penyebab dan pengelolaan yang tepat. Dalam beberapa kasus, pemeriksaan tambahan seperti pemeriksaan fungsi hati, pemeriksaan fungsi ginjal, dan pemeriksaan untuk mendeteksi infeksi atau kerusakan jaringan lainnya mungkin diperlukan 1. Oleh karena itu, penting untuk melakukan pemeriksaan yang komprehensif dan tepat untuk menentukan penyebab anemia hemolitik dan mengembangkan rencana pengelolaan yang efektif.

From the Research

Pemeriksaan Hematologi untuk Anemia Hemolitik

Berikut adalah beberapa jenis pemeriksaan hematologi yang dapat digunakan untuk mendiagnosis anemia hemolitik:

  • Pemeriksaan darah tepi (peripheral blood smear) untuk mengidentifikasi morfologi sel darah merah yang abnormal 2
  • Reticulocytosis, yaitu peningkatan jumlah retikulosit dalam darah, yang menunjukkan adanya produksi sel darah merah yang meningkat 2
  • Peningkatan lactate dehydrogenase (LDH) dalam darah, yang menunjukkan adanya kerusakan sel darah merah 2
  • Peningkatan bilirubin tidak terkonyugasi dalam darah, yang menunjukkan adanya pemecahan sel darah merah 2
  • Penurunan haptoglobin dalam darah, yang menunjukkan adanya kerusakan sel darah merah 2
  • Tes antiglobulin langsung (direct antiglobulin test) untuk membedakan penyebab imun dari non-imun 2

Klasifikasi Penyakit Hemolitik

Penyakit hemolitik dapat diklasifikasikan menjadi beberapa jenis, termasuk:

  • Hemoglobinopati, yaitu kelainan pada hemoglobin 2
  • Membranopati, yaitu kelainan pada membran sel darah merah 2
  • Enzimopati, yaitu kelainan pada enzim yang terkait dengan sel darah merah 2
  • Anemia imun-mediated, yaitu anemia yang disebabkan oleh sistem imun 2
  • Penyebab non-imun eksternal, termasuk trombotik microangiopati, trauma langsung, infeksi, penyakit sistemik, dan stres oksidatif 2

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Research

Hemolytic Anemia: Evaluation and Differential Diagnosis.

American family physician, 2018

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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