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A woman with glucose-6-phosphate dehydrogenase (G6PD) deficiency develops a urinary tract infection. Free radicals generated by responding neutrophils create an oxidant stress, and RBCs are rapidly overwhelmed. As soon as intravascular hemolysis begins, serum levels of which of the following will decrease?
A. Bilirubin
B. C-reactive protein
C. Free iron
D. Haptoglobin
E. Methemoglobin
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bilirubin due to hemolysis
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bilirubin would increase, not decrease. Try again
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You are right. Good job!!!!!!!!!!!!!!!!!!!!!!!!
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sorry read the question incomplete...
then i guess it is free iron?
not sure though
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The correct answer is D. Haptoglobin (or alpha-2 globulin) is a serum protein that promptly binds to free hemoglobin in the serum, forming a tight complex. The haptoglobin-hemoglobin complex is quickly cleared from the blood by the reticuloendothelial system, which allows the hemoglobin to be salvaged instead of lost into the urine. Intravascular hemolysis from any cause is rapidly followed by a dramatic drop in serum haptoglobin.
Bilirubin (choice A) is synthesized in the liver and spleen as an end-product of heme degradation. Serum bilirubin levels would not change until the haptoglobin in the blood was completely saturated, and free hemoglobin began to circulate. In this circumstance, serum bilirubin would increase, not decrease.
C-reactive protein (choice B) is an acute phase reactant produced by the liver in increased quantity in response to inflammation. This patient's urinary tract infection would increase C-reactive protein levels, but the hemolysis would not further affect them.
Serum free iron (choice C) does not change appreciably in intravascular hemolysis. Ferrous iron in the red blood cell is complexed to hemoglobin, and this complex is not broken in hemolysis.
Methemoglobin (an oxidized form of hemoglobin; choice E) increases in the blood along with free hemoglobin in cases of intravascular hemolysis.
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Thanks pcr for nice explanations, here is my little addition to this one
Haptoglobin will be decreased:
1)Hemolytic anemia
2)Transfusion reaction
3)Prostatic heart valves
4)SLE
5)Primary liver desease not associated with hemolytic anemia
6)Erythrobalstosis fetalis
7)Hematoma
8)Tissue hemorrhage
9)Chronic liver disease
