Blood Film
 

Red Blood Cell Colour

 
 
Bookmark

Overview

  • The intensity of the colour of red blood cells is representative of the red blood cell haemoglobin concentration.

Hypochromia

  • Hypochromia refers to a reduction in the intensity of red blood cell colour.
    • Hypochromia
    • Signs of Hypochromia

    • An increase in central pallor >⅓ of the cell on blood film
    • Reduced red cell haemoglobin (MCH / MCHC)
    • Hypochromia
       
    • Causes of Hypochromia

    • Microcytic

    • Iron deficiency anaemia
    • Anaemia of chronic disease (infection / inflammation / malignancy)
    • Thalassaemia
    • Congenital sideroblastic anaemia
    • Lead poisoning
    • Hyperthyroidism
    • Macrocytic

    • Copper deficiency

Hyperchromia

  • Hyperchromia refers to an increase in the intensity of red blood cell colour. Hyperchromic cells may be spherocytes, microspherocytes or macrocytes.
    • Hyperchromia
    • Signs of Hyperchromia

    • Reduction in central pallor on blood film
    • Increased red cell haemoglobin (MCH / MCHC)
    • Causes of Hyperchromia

    • Spherocytosis - hereditary spherocytosis, immune haemolysis, Clostridium
    • Microspherocytosis - microangiopathic haemolytic anaemia, severe burns
    • Macrocytosis - B12/folate deficiency chronic liver disease, alcohol abuse, hypothyroidism, post splenectomy, aplastic anaemia, myelodysplastic syndrome

Polychromasia

  • Polychromasia refers to macrocytic (large) red blood cells with a bluish tinge, due to residual RNA. These cells are likely reticulocytes, which are immature non-nucleated red cells which have only just extruded their nuclei.
    • Polychromasia
  • This finding may occur in the context of haemolysis, though may also be seen during recovery following haemorrhage or bone marrow suppression (such as following cytotoxic chemotherapy).
    • Causes of Polychromasia

    • Haemolytic anaemia
    • Haemorrhage (acute or chronic)
    • Recovery post bone marrow suppression
    • Late pregnancy
    • High altitude
Last updated on March 30th, 2020
 
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Explore
   
 
 

Read More...

 Adewoyin AS. Peripheral blood film-a review. Annals of Ibadan postgraduate medicine. 2014;12(2):71-9.
Antwi-Baffour S, Quao E, Kyeremeh R, Mahmood SA. Prolong storage of blood in EDTA has an effect on the morphology and osmotic fragility of erythrocytes. Int J Biomed Sci Eng. 2013;1(2):20-3.
 Bacon PA, Sewell RL, Crowther D. Reactive lymphoid cells ('Immunoblasts') in autoimmune and haematological disorders. Clinical and experimental immunology. 1975 Feb;19(2):201.
Bennett JM, Healey PJ. Spherocytic hemolytic anemia and acute cholecystitis caused by Clostridium welchii. New England Journal of Medicine. 1963 May 9;268(19):1070-2.
Brigden ML. Detection, education and management of the asplenic or hyposplenic patient. American family physician. 2001 Feb 1;63(3):499.
Gütgemann I, Heimpel H, Nebe CT. Significance of teardrop cells in peripheral blood smears. LaboratoriumsMedizin. 2013 Sep 1;37(5).
 Kobayashi SD, DeLeo FR. Role of neutrophils in innate immunity: a systems biology?level approach. Wiley Interdisciplinary Reviews: Systems Biology and Medicine. 2009 Nov 1;1(3):309-33.
Lawrence C, Atac BU. Hematologic changes in massive burn injury. Critical care medicine. 1992 Sep;20(9):1284-8.
 Mhawech P, Saleem A. Inherited giant platelet disorders: classification and literature review. American journal of clinical pathology. 2000 Feb 1;113(2):176-90.
Owen JS, Brown DJ, Harry DS, McIntyre N, Beaven GH, Isenberg H, Gratzer WB. Erythrocyte echinocytosis in liver disease. Role of abnormal plasma high density lipoproteins. The Journal of clinical investigation. 1985 Dec 1;76(6):2275-85.
Perrotta S, Gallagher PG, Mohandas N. Hereditary spherocytosis. The Lancet. 2008 Oct 18;372(9647):1411-26.
Shen SC, Ham TH, Fleming EM. Studies on the destruction of red blood cells: mechanism and complications of hemoglobinuria in patients with thermal burns: spherocytosis and increased osmotic fragility of red blood cells. New England Journal of Medicine. 1943 Nov 4;229(19):701-13.
 Van de Vyver A, Delport EF, Esterhuizen M, Pool R. The correlation between C-reactive protein and toxic granulation of neutrophils in the peripheral blood. SAMJ: South African Medical Journal. 2010 Jul;100(7):0-.
William BM, Corazza GR. Hyposplenism: a comprehensive review. Part I: basic concepts and causes. Hematology. 2007 Feb 1;12(1):1-3.
Feedback