Haptoglobin Serum

Anemia

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Commonly used to assess hemolytic anemia

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Haptoglobin Serum Test Information Guide

Why is it done?
- Measures haptoglobin, a protein produced by the liver that binds to free hemoglobin released from damaged red blood cells, facilitating their removal and recycling
- Detects and evaluates hemolysis (destruction of red blood cells) in various clinical conditions
- Ordered to diagnose hemolytic anemia, autoimmune hemolytic anemia, and other causes of red blood cell destruction
- Used to evaluate patients presenting with jaundice, dark urine, fatigue, and pallor suggesting hemolysis
- Monitors disease progression and treatment response in patients with known hemolytic conditions
- Typically performed when patients present with anemia symptoms, abnormal complete blood count results, or during evaluation for hemolytic disease
Normal Range
- Reference Range: 30-200 mg/dL (or 0.3-2.0 g/L), though values may vary slightly between laboratories
- Units of Measurement: Milligrams per deciliter (mg/dL) or grams per liter (g/L)
- Normal/Adequate Values: Indicates adequate haptoglobin levels and normal red blood cell survival; suggests minimal hemolysis
- Low/Decreased Values (< 30 mg/dL): Indicates hemolysis or excessive breakdown of red blood cells; haptoglobin is consumed binding to free hemoglobin
- High/Elevated Values (> 200 mg/dL): Suggests acute inflammatory response, chronic inflammation, or tissue damage; produced as part of acute phase response
- Absent/Trace Haptoglobin: Indicates significant or severe hemolysis; all haptoglobin has been depleted binding to excess free hemoglobin
Interpretation
- Decreased Haptoglobin Levels: Primary indicator of active hemolysis; suggests rapid destruction of red blood cells and consumption of haptoglobin reserves
- Increased Haptoglobin Levels: Occurs with inflammation, infection, tissue damage, or malignancy; also seen in some metabolic disorders; produced as acute phase reactant
- Factors Affecting Results:
  - Hemolytic conditions (hereditary spherocytosis, G6PD deficiency, thalassemia)
  - Autoimmune hemolytic anemia and transfusion reactions
  - Acute infections and sepsis causing reduced levels
  - Liver disease or hepatic dysfunction affecting haptoglobin synthesis
  - Chronic kidney disease may affect haptoglobin metabolism
  - Malignancy and lymphoproliferative disorders may elevate levels
  - Estrogen use and pregnancy can affect haptoglobin levels
- Clinical Significance: Haptoglobin is most useful in confirming hemolysis when combined with other markers such as elevated indirect bilirubin, elevated LDH, decreased reticulocyte count, and positive direct antiglobulin test (Coombs test); serial measurements help track disease progression and treatment efficacy
Associated Organs
- Primary Organs Involved:
  - Liver: Site of haptoglobin production and synthesis
  - Bone marrow: Site of red blood cell production; abnormalities affect RBC lifespan
  - Spleen: Primary site of RBC destruction and hemoglobin metabolism
  - Kidneys: Involved in haptoglobin metabolism and clearance
- Associated Medical Conditions:
  - Hemolytic anemias (hereditary spherocytosis, elliptocytosis, G6PD deficiency)
  - Autoimmune hemolytic anemia (warm and cold antibody types)
  - Thalassemia and sickle cell disease with hemolytic crises
  - Microangiopathic hemolytic anemia from mechanical heart valves or thrombotic thrombocytopenic purpura
  - Transfusion reactions and hemolytic disease of the newborn
  - Liver cirrhosis and hepatic insufficiency
  - Chronic infections (tuberculosis, endocarditis, osteomyelitis)
  - Malignancies including lymphomas and solid tumors
- Potential Complications from Abnormal Results:
  - Severe anemia leading to tissue hypoxia and cardiac compromise
  - Acute kidney injury from hemoglobinuria and free hemoglobin precipitation
  - Jaundice and hyperbilirubinemia from excessive bilirubin production
  - Hemosiderosis from chronic hemolysis and repeated transfusions
Follow-up Tests
- Recommended Complementary Tests:
  - Complete Blood Count (CBC) to assess hemoglobin, hematocrit, and reticulocyte count
  - Lactate Dehydrogenase (LDH) - elevated in hemolysis
  - Bilirubin (total and indirect) - typically elevated with hemolysis
  - Direct Antiglobulin Test (Coombs test) for autoimmune hemolytic anemia
  - Peripheral blood smear to visualize RBC morphology
  - Liver function tests (AST, ALT, albumin) if liver disease suspected
  - Renal function tests (creatinine, BUN) to assess kidney involvement
  - Reticulocyte count to assess bone marrow response to anemia
- Testing for Specific Hemolytic Conditions:
  - G6PD enzyme assay if glucose-6-phosphate dehydrogenase deficiency suspected
  - Hemoglobin electrophoresis for thalassemia or sickle cell disease
  - Osmotic fragility test for hereditary spherocytosis
  - Flow cytometry for paroxysmal nocturnal hemoglobinuria (PNH)
- Monitoring Frequency:
  - Acute hemolytic episodes: Repeat testing at 24-48 hours to assess disease progression
  - Chronic hemolytic conditions: Periodic monitoring (monthly to quarterly) during treatment
  - Response to therapy assessment: Testing 2-4 weeks after initiating treatment
Fasting Required?
- Fasting Required: No - Fasting is not required for serum haptoglobin testing
- Patient Preparation:
  - Blood test can be performed without fasting at any time of day
  - Normal diet and hydration are acceptable before testing
  - No specific medications need to be discontinued prior to testing unless instructed by physician
  - Inform healthcare provider of all current medications as some may affect results
  - Standard blood draw procedure using venipuncture into appropriate collection tubes
  - Minimal discomfort expected; same as routine venipuncture

How our test process works!