Hemoglobinuria (the appearance of hemoglobin in the urine) - is a sign of intravascular hemolysis of red blood cells. When hemoglobinuria urine dark brown. Hemoglobinuria precedes from hemoglobinemia.
In a healthy person in the bloodstream destroyed about 10% of red blood cells, so the plasma contains free hemoglobin in a concentration not exceeding 4 mg%. Free hemoglobin binds haptoglobin. Connection haptoglobin-hemoglobin does not pass kidney filter, as its MM is 160-320 kDa. The complex enters the retikulogistiotsitarnuyu system of the liver and spleen, where it undergoes cleavage to form the final products of pigment metabolism.
Hemoglobinuria occurs only in those cases where the level of plasma free hemoglobin exceeds the reserve capacity of haptoglobin to bind hemoglobin. In normal blood concentrations of haptoglobin, it is 100 mg%.
Intensity depends on the degree of hemoglobinuria from hemoglobinemia, the concentration of haptoglobin in blood and renal tubular resorption capacity.
At low plasma haptoglobin, and hemoglobinuria appears, without significant hemoglobinemia.
Gemoglobinemiya above 100-120 mg% causes increased reabsorption of hemoglobin cells of renal tubules. Reabsorbed hemoglobin is oxidized in the epithelium of proximal tubules in hemosiderin, ferritin. Hemosiderin-laden cells exfoliate and detected in urine. With a large number of hemosiderin in the urine sediment revealed unconfined hemosiderin. Gemoglobinemiya over 125 mg% is accompanied hemosiderinuria and hemoglobinuria.
Thus, the laboratory signs of intravascular hemolysis are hemoglobinemia, hemoglobinuria, hemosiderinuriya.
Intravascular hemolysis characteristic:
- paraksizmalnoy nocturnal hemoglobinuria (illness Marchiafawa - Michele)
- autoimmune hemolytic anemia
- post-transfusion reactions
- blood parasites (malaria)
- sickle-cell haemoglobinopathies
Increased hemolysis of red blood cells in the bloodstream is possible when:
- malignant tumors
- poisoning by snake venom, phenylhydrazine and other chemicals
If you have any questions about the diagnosis or treatment of hemoglobinuria, you can specify them with our urologist or a nephrologist on the phone: (499) 130-08-09
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