Common Erythrocyte abnormality (with Images)
Common Erythrocyte Shapes |
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| Shape | Definition | Associated Conditions |
| Discocyte | Biconcave disc | Normal RBC |
| Spherocyte | Spherical RBC (due to loss of membrane) | Hereditary spherocytosis, immune hemolytic anemia |
| Elliptocyte/Ovalcytes | Oval-shaped, elongated RBCs
• Elliptocytes: the RBC long axis is ≥2x the length of the short axis |
Hereditary elliptocytosis, megaloblastic anemia, myelofibrosis, iron-deficiency, MDS |
| Schistocytes (helmet cells) | Fragmented cells (due to traumatic disruption of membrane) | Microangiopathic hemolytic anemia (HUS/ TTP, DIC, pre-eclampsia, HELLP, malignant HTN), vasculitis, glomerulonephritis, prosthetic heart valve |
| Sickle cell | Sickle-shaped RBC (due to polymerization of hemoglobin S) | Sickle cell disorders: HbSC, HbSS |
| Codocyte (target cell) | “Bull’s eye” on dried film | Liver disease, hemoglobin SC, thalassemia, Fe deficiency, asplenia |
| Dacrocyte (teardrop cell) | Single pointed end, looks like a teardrop | Myelofibrosis, thalassemia major, megaloblastic anemia |
| Acanthocyte (spur cell) | Distorted RBC with irregularly distributed thorn-like projections (due to abnormal membrane lipids) | Severe liver disease (spur cell anemia), starvation/anorexia, post-splenectomy |
| Echinocyte (burr cell) | RBC with numerous regularly spaced, small spiny projections | Uremia, HUS, burns, cardiopulmonary bypass, post-transfusion, storage artifact |
| Rouleaux formation | Aggregates of RBC resembling stacks of coins Due to increased plasma concentration of high molecular weight proteins | Pregnancy: most common cause; due to physiological increase in fibrinogen Inflammatory conditions: due to polyclonal immunoglobulins.
Plasma cell dyscrasias: due to monoclonal paraproteinemia, eg. multiple myeloma, macroglobulinemia Storage artifact |
