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Hemosiderinuria (syn. haemosiderinuria) is the presence of hemosiderin in urine. [1] It is often the result of chronic intravascular hemolysis , in which hemoglobin is released from red blood cells into the bloodstream in excess of the binding capacity of haptoglobin .
The phenomenon tells that the detection of hemosiderin in urine is indicative of either ongoing or recent intravascular hemolysis characterized by excessive hemoglobin and/or met-hemoglobin filtered through the renal glomerulus as well as the loss of hemosiderin-laden necrotic tubular cells. [3]
Hemoglobinuria is a condition in which the oxygen transport protein hemoglobin is found in abnormally high concentrations in the urine. [1] The condition is caused by excessive intravascular hemolysis, in which large numbers of red blood cells (RBCs) are destroyed, thereby releasing free hemoglobin into the plasma. [2]
Hematuria can be classified according to visibility, anatomical origin, and timing of blood during urination. [1] [6]In terms of visibility, hematuria can be visible to the naked eye (termed "gross hematuria") and may appear red or brown (sometimes referred to as tea-colored), or it can be microscopic (i.e. not visible but detected with a microscope or laboratory test).
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Urine tests may show elevated hemoglobinuria and hemosiderinuria in chronic cases. Reticulocytosis may not be apparent in the acute phase or when there is viral-induced myelosuppression . [ 1 ]
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These early symptoms can include diarrhea (which is often bloody), stomach cramps, mild fever, [10] or vomiting that results in dehydration and reduced urine. [9] HUS typically develops about 5–10 days after the first symptoms, but can take up to 3 weeks to manifest, and occurs at a time when the diarrhea is improving. [ 10 ]