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Haemolytic specimens are a frequent occurrence in clinical laboratories, and they interfere with the analysis of many tests. We describe here an unusual case of leptospirosis complicated by haemolytic anaemia in a 70-year-old man with established kidney failure. He presented with an abrupt onset of shortness of breath, flushing and erythematous rash after completing haemodialysis. The patient's biochemistry test samples were however rejected twice as they were grossly haemolysed. The integrated auto-verification alert system implemented in the hospital's laboratory information system alerted the staff of the possibility of in vivo haemolysis. The auto-verification alert system effectively distinguishes between in vitro and in vivo haemolysis and as such can be utilised as a diagnostic aid in patients with suspected intravascular haemolysis.


Z Kathiravelu, S C Thambiah, M J Mat Salleh, I N Samsudin. Markedly raised haemolysis index with upper limit of normal serum potassium levels. The Malaysian journal of pathology. 2021 Apr;43(1):101-107

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PMID: 33903313

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