Poikilocytosis
Abnormally shaped red blood cells.
Significance
- Certain red cell morphologies may be more suggestive of certain causes of haemolysis.
Interpretation
- Schistocytes: small irregular fragments of red blood cells of varying shapesMicroangiopathic haemolytic anaemia, mechanical haemolysis, thalassaemia
- Sickle cells (drepanocytes): crescent-shaped cells caused by aggregation of haemoglobin SSickle cell disease
- Spherocytes: round cells with loss of central pallor, due to removal of a portion of the cell membrane by phagocytesHereditary spherocytosis, immune haemolysis, Clostridium
- Microspherocytes: small round cells with loss of central pallor (essentially spherocytic schistocytes)Hereditary spherocytosis, microangiopathic haemolysis, burns
- Irregularly contracted cells: loss of central pallor with an irregular borderOxidative haemolysis - G6PD deficiency, unstable haemoglobins, drugs
- Prekeratocytes (blister cells) - central holeOxidative haemolysis - G6PD deficiency, unstable haemoglobins, drugs
- Keratocytes (bite cells): bite-like defect in the membrane of the cell, due to phagocytosis of a Heinz bodyOxidative haemolysis - G6PD deficiency, unstable haemoglobins, drugs
Inclusion Bodies
Stainable material within red blood cells, mainly due to retained remnants of cellular components.
Interpretation
- Nucleated red blood cellsSevere anaemia, severe sepsis, hypoxia, myelofibrosis, bone marrow infiltration
- Heinz bodies (denatured haemoglobin): basophilic inclusions adjacent to the cell membrane on supravital stainingOxidative haemolysis - G6PD deficiency, unstable haemoglobins, drugs
Polychromasia
Red cells with a bluish tinge due to persistence of ribosomes.
Significance
- Indicative of reticulocytosis.
Causes of Polychromasia
- Haemolytic anaemia
- Haemorrhage (acute or chronic)
- Recovery post bone marrow suppression
- Late pregnancy
- High altitude
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