Abnormal RBCs Flashcards
Normal RBC
circular
biconcave shape
most hemoglobin in periphery, central pallor
come from pluripotent stem cell (bone marrow)
Negative Feedback Systems
Hypoxia occurs
causes kidney cells to release erythropoietin
bone marrow responds by releasing more immature RBC
What makes it normal?
arrangement size (morphology) color (morphology) shape (morphology) inclusions/parasites
Rouleaux
abnormal arrangement
stacking of erythrocytes
normal in horses (may be present in cats or pigs)
artifact of prolonged storage
Agglutination
cell arrangement
cells coated with antibodies
resulting in bridges or clumps
Agglutination causes
associated with immune disorders:
- IMHA (immune related hemolytic anemia)
- transfusions (wrong blood type)
- neonatal isorerythrolysis (in kittens and foals)-mother and baby blood types don’t match
Agglutination Versus Rouleaux
use a drop of saline
rouleaux will disperse in saline but agglutination will not
normal cell size
normocytic
increased cell size
macrocytic
decreased cell size
microcytic
abnormal cell size
anisocytosis
normal cell color
normochromic
increased cell color
spherocyte
decreased cell color
hypochromic
normal cell shape
biconcave disk with central pallor
abnormal cell shape
poikilocytosis
What species of animal is anisocytosis normal in?
cattle
Polychromasia
abnormal color
RBCs with bluish macrocytes
presence of organelles within cytoplasm
immature cells
(if stained blue=reticulocytes)
What condition do animals suffer from when their RBCs are hypochromic?
anemia
Spherocytes
abnormal color
darkly stained RBCs
appearance too much hemaglobin (but not true)
usually microtic
lost biconcave shape
Poikilocytosis
abnormal shape
abnormal shape
not helpful in diagnosis
only use when morphologies can be made more specific
5 Categories of RBC Morphology
- Regenerative response (response to anemia)
- Immune mediated damage (body does not recognize self
- Oxidative injury (onions, tylenol, etc.)
- Membrane/metablic disorder
- Mechanical fragmentation (physical damage)
Immune mediated damage
body’s immune system went haywire
IMHA
Incompatible blood transfusions
Neonatal Isoerthrolysis
Immune mediated damage RBC Morphology
changes seen in:
spherocytes
agglutination
ghost cells
spherocytes
dark
no disk shape
agglutination
cell clumping
ghost cells
remnants of membrane due to intravascular lysis
Oxidative Injury
areas with denatured hemoglobin or hemoglobin pushed to the side
unable to carry oxygen
causes: oxidant drugs and chemicals, garlic, onions, acetominophen
Oxidative Injury RBC Morphology
Changes seen in:
heinz bodies
eccentrocytes
Eccentrocytes
half clear, pushed out hemoglobin
causes: diabetes ketoacidosis, neoplasia, Babesia canis, ingestion of toxin (garlic, onions, acetaminophen
Heniz bodies
round, blue
normal in cats in 5% RBC
indicate: lymphosarcoma, hyperthyroidism, diabetis mellitus
Mechanical Fragmentation
fragmented RBCs
not a good sign in large numbers
caused by intravascular trauma or mylofibrosis
Mechanical Fragmentation RBC Morphology
Changes seen in:
schistocytes
dacryocytes
Schistocytes/shizocytes
traveling through fibrin (clot)
often seen in DIC (disseminated intravascular coagulation)
Dacryocytes
tear drop shaped cells
(if all face the same way may be artifact or spreading)
cause may be fragmentation or mylefibrosis (bone marrow scars)
cause unknown may be secondary to lymphoma or leukemia
Membrane/Metabolic Disorders
many different processes or illnesses can cause variation
Membrane/Metabolic Disorders RBC Morphology
Changes seen in:
Echinocytes Acanthocytes Keratocytes Hypochromasia Torocytes Ovalocytes/Elliptocytes Leptocytes (Codocyes, Knizocytes) Stomatocytes
Echinocytes (bur cells)
regular spikes, hedgehog or bur appearance
Causes:
in vivo= renal disease (lymphosarcoma) or snake bites
in vitro=crenation
Acanthocytes (spur cells)
nickelodeon, splat, or spur appearance
Causes:
liver disease
dogs with hematuria
Keratocytes (blister, bite, helmet cells)
helmet appearance
areas of cell membrane damage
causes:
hemangiosarcoma, neoplasia, glomerularnephritis, liver disease
Torocytes (punched out cells)
an artifact of spreading the blood
normal cells
Stomatocytes
mouth appearance
central pallor is oval
Causes: hereditary, lead poisoning, drying artifact
Ovalicytes/Elliptocytes
normal in camelids (llamas)
Causes:
lymphoblastic leukemia, hepatic lipidosis, portosystemic shunt, glomerular nephritis
Leptocytes
cell membrane too large for hemaglobin
folding cell membrane
examples:
codocytes
knizocytes
Codocytes (target cells)
causes:
liver disease or
polychromatophil
Knizocytes (bar cells)
similar to target cells but line or bar near central pallor
Pseudoparasites
stain precipitate basophilic stippling (lead poisoning) pappenheimer bodies retractile bodies (water in stain) platelets (stuck to RBC) Howell Jolly Bodies (immature, remnant of nucleus)
Parasites and Inclusions: Ruminants
Anaplasma marginale
often seen in cows=anemia and death
Parasites and Inclusions: Canines
Viral Inclusions: Distemper
Mycoplasma haemocanis=splenectomy
Babesia Canis=anemia, icterus
Parasites and Inclusions: Felines
Mycoplasma haemofelis=common cause of FIA (from queen to kittens or via vectors), aka “Hemogbart=splenectomy
