Black pigment gallstones (made of calcium bilirubinate), may lead to cholecystitis
Diagnostics
Normocytic anemia: mean cell volume (MCV) within normal range (80-100 fL) or slightly decreased
Increased mean corpuscular hemoglobin concentration (MCHC)
The increase in MCHC is the result of a decrease in RBC cell volume (caused by a decrease in RBC water content), whereas the hemoglobin content remains constant.
↑ Red blood cell distribution width (↑ RDW)
This finding is highly suggestive of HS!
↑ Reticulocytes (normal range: 0.5%–1.5% of total RBC count)
Findings of hemolytic anemia
↑ Unconjugated bilirubin
↓ Haptoglobin
↑ LDH
Eosin-5-maleimide binding test (EMA binding test)
Test of choice, as results are readily available (within two hours)
Decreased binding between dye (eosin-5-maleimide) and RBC membrane proteins
Binding is quantified using flow cytometry, which shows decreased mean fluorescence