RBC Abnormalities and Associated Diseases
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RBC Abnormalities and Associated Diseases
- 1. ERYTHROCYTEABNORMALITIES AND ASSOCIATION WITH DISEASESTATES RBC ABNORMALITY CELL DESCRIPTION ASSOCIATED DISEASE STATE ANISOCYTOSIS Severe size variation Severe anemia(e.g.,megaloblastic,irondeficiency) Macrocytes Large cells(>8um),MCV >100 fL Megaloblasticanemia(B12 orfolate deficiency) Liverdisease Hemolyticanemia:increasedreticulocytes Myeloma Macrocytosis:newborns Myelophthisicanemia Oval macrocytes Large oval cells Megaloblasticanemia Microcytes Smallerthannormal cell (<6 um) MCV <80 fL Iron deficiencyanemia Sideroblasticanemia Thalassemia Lead poisoning POIKILOCYTOSIS Abnormal shape variation Severe anemia;certainsshapesare helpful diagnostically SECONDARY TO MEMBRANE ABNORMALITIES: Acanthocytes Small cell withfew,irregularlyspacedspicules of varyinglength Microangiopathichemolyticanemia(MAHA) Alcoholicliverdisease Hereditaryacanthocytosis Abetalipiproteinemia Burr cells RBCs withuniformlyspaced,pointedprojectionsontheirouter edges. Liverdisease Uremia Hemolyticanemia Microangiopathichemolyticanemia(MAHA) Thromboticthrombocytopenicpurpura(TTP) Disseminatedintravascularcoagulation(DIC) Carcinoma(stomach) Pyruvate kinase deficiency Codocytes Hypochromiccell withcentral areaof hemoglobinpigment Obstructive liverdisease Hb SS, SC,S thalassemia Thalassemia Iron deficiency Postsplenectomy Echinocytes/ CrenatedRBC Equallyspaced,(10-30)shortbluntprojections Renal disease
- 2. ERYTHROCYTEABNORMALITIES AND ASSOCIATION WITH DISEASESTATES RBC ABNORMALITY CELL DESCRIPTION ASSOCIATED DISEASE STATE Elliptocytes/ Ovalocytes Oval or elliptical shapedcells Hereditaryelliptocytosis Iron deficiency Megaloblasticanemia Thalassemia Myelophthisicanemia Stomatocyte RBCs withslit-like areaof central pallor Hereditarystomatocytosis Obstructive liverdisease Alcoholism,cirrhosis Rhnull disease Artifact Spherocytes Small,round,dense cellswithlackof central pallor;usually microcytic Hereditaryspherocytosis DAT-positivehemolyticanemia Otherhemolyticanemias(e.g.,Heinzbodyhemolyticanemia) Aftertransfusion Fragmentationhemolysis SECONDARY TO TRAUMA: Blistercells(marginal achromia) Raisedportionof membrane appearingfree of hemoglobin Microangiopathichaemolyticanemia(MAHA) Thromboticthrombocytopenicpurpura(TTP) Hemolytic-uremicsyndrome (HUS) Hb SS withpulmonaryemboli Dacryocytes Cell withone pointedextremity(inshapeof drop) Myelofibrosiswithmyeloidmetaplasia Ineffective erythropoiesis Myelophthisicanemia Thalassemia Megaloblasticanemia Keratocytes Cell fragmentin shape of a helmet DIC, MAHA,TTP, HUS Schistocytes/ Schizocytes Fragmentedcells,irregularlycontractedcells DIC, MAHA,TTP, HUS Uremia,carcinoma,severe burns Heart valve hemolysis March hemoglobinuria
- 3. ERYTHROCYTEABNORMALITIES AND ASSOCIATION WITH DISEASESTATES RBC ABNORMALITY CELL DESCRIPTION ASSOCIATED DISEASE STATE SECONDARY TO ABNORMAL HEMOGLOBIN: Drepanocyte RBCs inthe shape of a sickle orcrescentdue to the formationof rod-like polymersof hemoglobinSwithinthe cell. Sickle cell anemia Hb SC disease,HbSβthalassemia Hb O-Arab ABNORMAL DISTRIBUTION Rouleaux Redcellsappearas stacks of coinson the peripheral smear Waldenstrom’smacroglobulinemia Multiple myeloma Chronicinflammatorydisorders Some lymphomas Agglutination Redcellsaggregate intorandomclustersormasses Coldhemagglutinindisease Paroxysmal nocturnal hemoglobinuria Hemolyticanemias Staphylococcal infections Atypical pneumonia