"Mechanism:
spleen and liver macrophages :
- ingest small portions of the RBC membrane creating spherocytes or
- phagocytethe RBCs.
Biochem:
- Hemoglobin is broken down intracellularly.
- Free hemoglobin is not released directly into the blood and urine.
- Hemoglobin breakdown products are increased (hyperbilirubinemia)
- Haptoglobin does not decrease
- No haemoglobinuria
- No haemosiderinuria
LDH increases as in Intravascular haemolysis
Others:
Hepatosplenomegaly since these are sites of RBC destruction.
Chronically elevated levels of bilirubin promote gallstones."