1. What is Hemolysis?
- Hemolysis means the
destruction or rupture of red blood cells (RBCs).
- When RBCs
burst, hemoglobin is released into the blood plasma.
- Can happen
inside the body (intravascular) or outside (during lab
testing).
Mnemonic: “He-MO-Lysis” = Hemoglobin Moves Out due to Lysis
2. Types of Hemolysis
|
Type |
Where it Happens |
Example |
|
Intravascular |
Inside blood vessels |
Mismatched blood transfusion |
|
Extravascular |
In spleen/liver |
Autoimmune hemolytic anemia |
|
In vitro |
Outside body (in lab) |
Improper blood sample handling |
3. Causes of Hemolysis
Mnemonic: “SHIRT”
- S – Sickle
Cell Anemia
- H –
Hereditary Spherocytosis
- I –
Infections (like malaria)
- R –
Reactions (transfusion mismatches)
- T – Toxins
& Drugs (e.g., snake venom, sulfa drugs)
4. Effects of Hemolysis
- Hemoglobinemia – Free Hb
in blood
- Hemoglobinuria – Hb in
urine
- Jaundice – ↑
Unconjugated bilirubin
- Anemia – Due to
RBC destruction
- Splenomegaly – If extravascular
Mnemonic: “HAJHS”
Hemoglobinemia, Anemia, Jaundice, Hemoglobinuria, Splenomegaly
5. Lab Hemolysis (In
vitro)
- Happens outside
the body, often due to:
- Shaking
blood sample
- Using a
small needle
- Drawing
blood too fast
- Causes false
test results like falsely low potassium or calcium.
6. What is Fragility of
RBCs?
- Refers to
the sensitivity of RBCs to break down in a hypotonic (diluted
salt) solution.
- Osmotic
Fragility Test is used to check how easily RBCs rupture.
7. Osmotic Fragility
Test
- RBCs
placed in decreasing concentrations of NaCl (salt) solution.
- Normal
RBCs start hemolysis at 0.48% NaCl and complete at 0.36%.
- If RBCs
are more fragile, they burst earlier (e.g., spherocytosis).
- If less
fragile, they resist bursting (e.g., thalassemia, sickle cell).
Mnemonic: “SALTY Cells BURST”
8. Osmotic Fragility in
Diseases
|
Disease |
Fragility Status |
|
Hereditary spherocytosis |
Increased (burst early) |
|
Thalassemia |
Decreased (burst late) |
|
Sickle cell anemia |
Decreased |
|
Normal |
Standard range |
9. Why Does Fragility
Change?
- Depends on
the structure and flexibility of the RBC membrane.
- If RBCs
are rigid or misshapen, they rupture easily.
- If RBCs
are flexible or thin, they resist bursting.
10. Uses of Osmotic Fragility
Test
- Diagnose hereditary
spherocytosis
- Differentiate
types of anemia
- Check membrane
integrity of RBCs
Quick Mnemonics Recap:
|
Concept |
Mnemonic |
|
Causes of Hemolysis |
SHIRT |
|
Effects of Hemolysis |
HAJHS |
|
Fragility Test Idea |
SALTY Cells BURST |
|
Hemolysis Meaning |
He-MO-Lysis |
FAQs – Frequently Asked Questions
Q1. What is hemolysis?
Ans: Hemolysis is the breaking of red blood cells leading to the release of
hemoglobin into the plasma.
Q2. What causes
hemolysis?
Ans: Causes include sickle cell anemia, hereditary spherocytosis, mismatched
blood transfusion, malaria, and certain toxins or drugs.
Q3. What is osmotic
fragility?
Ans: Osmotic fragility refers to the ability of RBCs to withstand bursting
in hypotonic (dilute salt) solution.
Q4. Which condition
shows increased osmotic fragility?
Ans: Hereditary spherocytosis shows increased fragility (RBCs rupture early
in dilute solution).
Q5. What happens to
plasma in hemolysis?
Ans: Plasma becomes pink or red due to the presence of free hemoglobin.
Q6. What is the
significance of the osmotic fragility test?
Ans: It helps diagnose RBC membrane disorders like hereditary
spherocytosis and differentiate between types of anemia.
