Q: I am a 34 years old male. I'm suffering from haemolytic anaemia for the past 16 years. My gall bladder was removed eight years back. I'm also having gout for the past three and half years. According to the recent reports, I have developed fatty liver disease. My liver size is supposed to be 15cms and with mild echotexture. The triglycerides level is 256 where the range is 60-160. Urine for bile salts and bile pigments are positive. Urine for urobilinogen is positive. Mild anisocytosis and increased osmotic fragility has been observed. The control samples are 0.40 (initial) and 0.28 (complete) and the patient samples are 0.52 and 0.30 SGOT - 26 (14-50) and SGPT -55 (13- 61). Serum uric acid is 10.5 mg/dl (3.5-8.5). Are these figures OK? Please advise.

A:Haemolysis is the premature break down of red blood cells. This can lead to anaemia (haemolytic anaemia) when the bone marrow cannot compensate for the red cell loss. Clinical presentation of a patient depends on whether the onset of haemolysis is gradual (chronic) or abrupt (acute) and on the severity of red cell break down. Haemolytic anaemia may be due to a large number of hereditary or acquired causes. In nearly 50% of cases, no cause may be found. The treatment depends on the underlying cause. Please exclude the possibility of hereditary spherocytosis. The laboratory abnormalities seen include an increase in lactic acid dehydrogenase (LDH), indirect bilirubin and urobilinogen, among others. Please consult a haematologist who can select appropriate diagnostic tests and plan & monitor your treatment. You need to take iron (if deficient) and folic acid supplement. Ideally, you should be investigated in an experienced laboratory.