Impact of Hemolysis on Hematology Testing

Learning Objectives:

• recognize complete blood cell count abnormalities that may indicate interference due to hemolysis;
• take appropriate action to correct for interferences or initiate re-collection;
• describe the pattern of laboratory findings associated with each of the major subtypes of hemolysis encountered in the laboratory (artifactual, intravascular, and extravascular);
• correlate hemolysis and blood film findings to define the likely diagnostic reason(s) for the abnormalities;
• recognize cases in which sample hemolysis may be physiologic and re-collection may therefore not be indicated;
• systematically evaluate additional causes of high mean corpuscular hemoglobin concentration; and
• correct or add a disclaimer to results with high mean corpuscular hemoglobin concentration as appropriate.