To help detect and evaluate haemolytic anaemia
Haptoglobin
When you have signs of jaundice, or of anaemia such as weakness, paleness, or breathlessness that the doctor suspects may be due to red blood cell destruction (haemolytic anaemia).
A blood sample taken from a vein in your arm.
No test preparation is needed.
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How is it used?
Haptoglobin testing is used mainly to help diagnose and monitor haemolytic anaemia and to distinguish it from anaemia due to other causes; however, it cannot be used to diagnose the cause of the haemolysis.
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When is it requested?
The haptoglobin test may be requested if you have symptoms and signs of anaemia, such as paleness and weakness, along with findings suggestive of haemolytic anaemia, such as jaundice and dark urine. The test may be used with a reticulocyte count and a blood film when you have an abnormally low RBC count, haemoglobin, and/or haematocrit test result. It may also be used with a direct antiglobulin test when you have had a blood transfusion and are suspected of having a transfusion reaction or to investigate a suspected autoimmune haemolytic anaemia. The doctor may also request the test alongside a total or indirect bilirubin test.
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What does the test result mean?
When haptoglobin levels are decreased, along with an increased reticulocyte count and a decreased RBC count, haemoglobin, and haematocrit, then it is likely that you have some degree of haemolytic anaemia.
If the haptoglobin is normal and the reticulocyte is increased, then RBC destruction may be occurring in organs such as the spleen and liver (called “extravascular” rather than “intravascular” haemolysis). Because the freed haemoglobin is not released into the bloodstream, the haptoglobin is not consumed and so is normal.
If the haptoglobin levels are normal and the reticulocyte count is not increased, then it is likely that the anaemia present is not due to RBC breakdown.
If haptoglobin levels are low without any signs of haemolytic anaemia, then it is possible that the liver is not producing adequate amounts of haptoglobin.
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Is there anything else I should know?
Haptoglobin is an “acute-phase” protein; this means that it will be increased in many inflammatory diseases, such as ulcerative colitis, acute rheumatic disease, heart attack, and severe infection. This can complicate the interpretation of the haptoglobin results. Haptoglobin testing is not used to help diagnose or monitor these conditions.
Haptoglobin levels may be affected by massive blood loss and by conditions associated with kidney dysfunction, as well as liver disease.
Drugs that can increase haptoglobin levels include androgens and corticosteroids such as prednisolone. Drugs that can decrease haptoglobin concentrations include isoniazid, quinidine, streptomycin, and birth control pills.
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If haptoglobin levels are decreased, when will they return to normal?
It depends on the cause of the decrease. If it is due to acute haemolysis, such as may be seen with a transfusion reaction, then it will return to normal once the donor blood has been cleared from the system. If it is due to chronic haemolysis, then the levels should return to normal levels if the underlying condition can be treated. If the underlying condition cannot be treated or if the decreased levels of haptoglobin are due to reduced production due to liver disease, then levels may continue to be lower than normal.