First, they damage the RBC membrane, resulting in intramedullary hemolysis, or RBC breakdown in the bone marrow; or extravascular hemolysis, when RBCs are destroyed by macrophages in the spleen.

首先，它们会坏红膜，导致内（中红分解）或管外（红被脾脏的巨噬坏）。

With extravascular hemolysis, we have macrophages eating up red blood cells more than normal and unconjugated bilirubin production is ramped up, which is conjugated by the liver and sent to the gallbladder.

管外时，巨噬吞噬红，较正常时更多，进而加速了非结合胆红素的产生，非结合胆红素在肝脏转变为结合胆红素，并输送至胆囊。