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|Clinical Questions||Is my patient actively hemolyzing his/her own or transfused RBCs?|
|Utilization Guidelines||Should only be ordered in anemic patients when peripheral smear review, reticulocyte counts, and Coombs testing have failed to elucidate the cause.|
|In House Availability||Monday, Wednesday, Friday (day shift)|
|Container type||Gold top|
|Amount to Collect||1 mL blood|
|Preferred volume||0.5 mL serum|
|Min. Volume||0.3 mL serum|
|UCSF Rejection Criteria||Hemolyzed, Lipemic samples|
|Processing notes||Refrigerate serum.|
|Normal range||36-195 mg/dL|
|Turn around times||2-5 days|
|Additional information||Haptoglobin is a serum protein that binds hemoglobin irreversibly.This protein functions to transport intravascular free hemoglobin to its degradation site in the reticulo-endothelial system. Haptoglobin normally is expected to decrease during active hemolysis; however, haptoglobin is an acute phase reactant, thus normal or elevated levels do not exclude the presence of hemolysis. Further, some individuals may normally have very low levels of haptoglobin at baseline and therefore testing in these individuals may result in a false impression of hemolysis. For the test to be reliably interpreted, it is best to compare a result with the patient's baseline level.
Further, haptoglobin does not provide information as to the cause of the hemolysis and therefore rarely results in changes in therapy. In patients with suspected hemolysis, the suspicion is more easily strengthened by determining LDH and bilirubin levels. If these are elevated, then determining a reticulcyte count as a confirmatory test and examining the patient's peripheral smear for red cell features that may offer information as to the cause of the hemolysis would be appropriate.
|Last Updated||1/30/2013 11:43:21 AM|