Final answer:
Lactate dehydrogenase (LDH) is the enzyme that may be elevated in cases of hemolytic anemia. A complete blood count and reticulocyte count can confirm this, and a decrease in haptoglobin is also commonly seen. Patients with G6PD deficiency are particularly susceptible to oxidative stress leading to hemolytic anemia.
Step-by-step explanation:
The enzyme that may be elevated in hemolytic anemia, both extra- and intravascular, is Lactate dehydrogenase (LDH). This enzyme serves as a marker of the severity of hemolysis. In the case of hemolytic anemia, a Complete blood count and reticulocyte count can be helpful in diagnosis, with the presence of Heinz bodies in red blood cells on a blood film indicating active hemolysis due to conditions such as G6PD deficiency. Other intracellular enzymes such as Isocitric dehydrogenase, phosphorylase, Kinase, and phosphofructokinase may also be released into the blood due to cellular damage, which is a secondary sign of tissue damage.
Patient testing may also reveal a decreased haptoglobin level, which binds free hemoglobin released by red cells and is used up quickly in cases of hemolysis. In patients with G6PD deficiency, they are especially at risk of hemolytic anemia during states of oxidative stress, where essential cellular components such as glutathione are depleted, resulting in damage to red blood cells and a subsequent rise in byproducts like bilirubin.