Haemoglobinuria

Causes	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 to exclude haematuria; haemoglobin - urine, myoglobin - urine (if indicated). FBC, 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.
Malaria	See under Haemolysis.
Recurrent or chronic intravascular haemolysis
Microangiopathic haemolysis, especially Cardiac valve haemolysis Haemangioma	Haemosiderin - urine.
Paroxysmal nocturnal haemoglobinuria	See under Autoimmune haemolysis.
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.

Glossary Terms