تفسیر مورفولوژی گلبولهای قرمز

تفسیر مورفولوژی گلبولهای قرمز

Size of normal red cells

7.5 micrometers(mm)in diameter

Characteristics of normal RBC

Central concavity and pallor

Variation in size of RBC's is called Anisocytosis.

Anisocytosis is encountered in

Megaloblastic anemia
Iron deficiency anemia
Variation in shape. Abnormal shapes of red blood cells

Poikilocytosis

Megaloblastic anemia
Iron deficiency anemia
Microcytic and Hypochromic : Smaller than normal with prominent central pallor

Iron deficiency anemia Causes include: Blood loss Pregnancy Impaired GI absorption
Beta Thalessemia
Sideroblastic anemia
Macrocytic : Larger than normal

Chronic hepatic disorders, i.e. cirrhosis, chronic hepatitis
Alcoholism
Hypothyroidism
Megaloblastic anemia (Vitamin B12 or folate deficiencies)
Myelodysplasia
 

Sickle Cells: Elongated crescentic red blood cells

Sickle cell hemoglobinopathies (e.g.SS,SC, S-thalassemia)
Rarely seen in sickle trait(AS)smear.
 

Elliptocytes: Cells are elliptical in shape.

Hereditary elliptocytosis
Thalassemia
Iron Deficiency
 

Target Cells: Central and outer rim staining with intervening ring of pallor

Liver disease
Thalessemia
Hemoglobin C disease
Sickle cell disease
 

Acanthocytes: Also called Spur cells Irregularly spiculated . Dense center.

Due to altered cell membrane lipids

Severe liver disease
Abetalipoproteinemia
Rarely seen in anorexia nervosa
Malabsorption
Post Splenectomy
 

Polychromatophilia: Reticulocytes: Blue hue in macrocytes

Hemolytic anemia
Thalassemia Major
Autoimmune Hemolysis
Hemorrhage
After replacement of Iron, B12, Folate
 

Rouleaux Formation: Alignment of red blood cells in stacks (more than 4-5 per stack)

Paraproteinemia as in multiple myeloma or macroglobulinemia
High fibrinogen (inflammatory states; high ESR)
Artifactual
Howell jolly bodies : small basophilic dense inclusion

Post Splenectomy
Hemolytic anemia
 

Spherocytes : Small hyperchromic cells lacking normal central pallor.

Hereditary spherocytosis
Immune hemolytic anemia
Post transfusion
Glucose-6-phosphate dehydrogenase deficiency(Heinz body hemolytic anemias)