Red Blood Cell Morphological Abnormalities

This is a video describing various morphological abnormalities found in red blood cells, including changes in red cell size, shape, color, and distribution.  

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ADDITIONAL TAGS:
Macrocytosis
Large  
As measured with MCV
 altered DNA synthesis
MCV,
 things that alter DNA synthesis ,   B12/folate deficiency
Liver disease
Thyroid disease
Chemotherapy
Anti-retrovirals (AZT)
Microcytosis
Small  
Measured with MCV
 iron deficiency, thalassemia, lead poisoning
measured with MCV,
 Iron deficiency, Thalassemias, Lead poisoning, Sideroblastic anemia
Anisocytosis
Wide range of RBC sizes
High red cell distribution width (RDW)
Hypochromasia
  with too little hemoglobin
Measured with mean corpuscular Hb (MCH)
  hypochromic cells, central cell diameter
caused by lack of hemoglob   (iron defiiciency, thalassemia, liver problems)
Polychromasia
  that are shaded grayish blue
often reticulocytes (immature    )
Anisocytosis, large RDW
Poikilocytosis
  that vary widely    shape
Analogous    anisocytosis
anisocytosis - vary    size
poikilocytosis - vary    shape
Target cells
 codocytes
Related    liver disease, thalassemias, hemoglob   C, post-splenectomy
Normal RBC
cross section
Target cell
Anisocytosis, large RDW
Spherocytes
Spherical     (instead of biconcave disk-shaped
Appears on blood smear as loss of central pallor
Hereditary spherocytosis
Autoimmune hemolysis
Normal RBC Spherocyte
cross section cross section
(biconcave disk) (more spherical)
Ab attack membrane of RBC, if you pull out chunks of membrane, surface area of RBC membrane decreases
Schistocytes
  fragments
Sharp edges
Can be caused by plaque on arterial walls that shear    
Also   Microangiopathic Hemolytic Anemia (MAHA)
Sickle cells
  fragments
 sickle cell anemia
Hemoglob   molecules with
Point mutation that changes glutamic acid    valine
Polymerization of Hb at low pH, low pO2, high temperature
Anisocytosis, large RDW
Echinocytes
 burr cells
Projections that are regular
 renal disease
Acanthocytes
 spur cells
Projections that are irregular     large
 liver disease
Teardrop cells
 dacrocytes
Caused by infiltration of bone marrow (myelophthisic processes)
Something    body (  lymphocytes, scar tissue, cancer) enters     grows    bone marrow
Linear aggregations or “stacks” of  
           are high levels of immunoglobulins
   usually have similar surfaces charges that keep them from sticking together
Immunoglobulins neutralize these charges, allow        attract with charge-charge interactions
  a normal patient, you might see this on dense side of a blood smear, bc RBC conc is more concentrated    
Agglutination
  collect      clumps
Less orderly than rouleaux
are coated with IgM, which bridge     together    cause aggregation
Howell-Jolly Bodies
Remnants of nucleic acids that found postsplenectomy
Look like little purple dots

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