Appropriate Tests


Urinalysis (dipstick); this is a reliable test for haemoglobin in urine if properly performed, but does not distinguish haemoglobinuria from haematuria and myoglobinuria.

Urine microscopy (MCS urine) to exclude haematuria, Haemoglobin urine, Myoglobin urine (if indicated).

Full blood count, Blood film.

See Haemolysis, Coloured urine, Haematuria, Myoglobinuria.

Acute intravascular haemolysis


Haemolytic blood transfusion reaction

See under Blood transfusion - transfusion reactions.

Cold antibody haemolysis, especially

  • Mycoplasma infection
  • Infectious mononucleosis
  • Lymphoproliferative disorders

See under Autoimmune haemolysis.

Chronic cold agglutinin disease may present as acute haemolysis with haemoglobinuria.

Acute drug-induced oxidative haemolysis

See under Haemolysis.

Severe burns 

See under Haemolysis.

Clostridium perfringens septicaemia

See under Haemolysis.

Snake bite

See under Haemolysis.


See under Haemolysis.

Recurrent or chronic intravascular haemolysis


Microangiopathic haemolysis, especially

  • Cardiac valve haemolysis
  • Haemangioma

Haemosiderin urine.

Paroxysmal nocturnal haemoglobinuria (PNH)

Paroxysmal nocturnal haemoglobinuria

Intrinsic red cell defects, especially

  • G-6-PD deficiency
  • Sickle cell anaemia
  • Pyruvate kinase deficiency

May be associated with chronic, continuing haemolysis, or acute episodes in association with drugs, intercurrent illness.

See under Haemolysis.

See under Sickle cell disorders and Haemolysis.

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