Common Erythrocyte abnormality (with Images)

Common Erythrocyte Shapes

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
• Ovalcytes: 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




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