pseudohämolyse

Pseudohämolyse refers to the appearance of red blood cells that resemble hemolysis but are not caused by the actual rupture of red blood cells. This phenomenon can occur in various situations, leading to potential misinterpretations in laboratory diagnostics.

One common cause of pseudohämolyse is mechanical damage to red blood cells during blood collection or processing. Vigorous shaking, rapid aspiration through a small needle, or improper centrifugation can fracture red blood cells, releasing hemoglobin into the plasma without true cell lysis. This can mimic the results seen in true hemolytic anemia.

Another cause is the presence of certain substances in the blood sample. For instance, high concentrations of lipids (lipemia) can refract light, creating an illusion of red blood cell breakdown. Similarly, very high protein levels or the presence of abnormal proteins can also interfere with spectrophotometric analysis, leading to falsely elevated hemoglobin readings.

Certain physiological conditions can also contribute to pseudohämolyse. In cases of severe hyperkalemia, potassium can leak from red blood cells, causing them to shrink and appear distorted, which can be mistaken for hemolysis. In some individuals, temperature variations during sample handling can also induce changes in red blood cell morphology that mimic lysis.

Distinguishing pseudohämolyse from true hemolysis is crucial for accurate diagnosis and treatment. Careful examination of the peripheral blood smear under a microscope can often reveal the cause. The presence of fragmented red blood cells, acanthocytes, or other red blood cell abnormalities can point towards mechanical damage or specific pathological conditions rather than genuine hemolysis. Laboratory personnel must be aware of these potential artifacts to avoid diagnostic errors.