Pathologic RBC Forms

Question 1

Acanthocytes

Answer 1

“spur cells”

Liver disease
abetalipoproteinemia (cholesterol dysregulation)

Question 2

Basophilic stippling

Answer 2

Lead poisoning
Sideroblastic anemia
Myelodysplastic syndromes

Question 3

Dacrocyte

Answer 3

“teardrop cell”

Bone marrow infiltration (e.g. myelofibrosis)

Question 4

Degmacyte

Answer 4

“bite cell”

G6PD deficiency

Question 5

Echinocyte

Answer 5

“burr cell”

(smaller projections that are more uniform than an acanthocyte)

End-stage renal disease
Liver disease
Pyruvate kinase deficiency

Question 6

Elliptocyte

Answer 6

Hereditary elliptocytosis - mutation in genes encoding RBC membrane proteins (e.g. spectrin)
usu asymptomatic

Question 7

Macro-ovalocyte (and hypersegmented neutrophil)

Answer 7

Megaloblastic anemia

Marrow failure

Question 8

Ringed sideroblast

Answer 8

Excess iron in mitochondria

Sideroblastic anemia

Question 9

Schistocyte

Answer 9

“helmet cells”

DIC
TTP/HUS
HELLP syndrome
mechanical hemolysis (e.g. heart valve prosthesis)

Question 10

Sickle cell

Answer 10

Sickling occurs w dehydration, deoxygenation, high altitude

Sickle cell anemia

Question 11

Spherocyte

Answer 11

w reduced central pallor

Hereditary spherocytosis
drug and infection induced hemolytic anemia

Question 12

Target cell

Answer 12

HbC disease
Asplenia
Liver disease 
Thalassemia 
(HALT)

Question 13

Heinz bodies

Answer 13

Hb precipitation due to oxidation of Hb-SH groups to S-S
Subsequent phagocytic damage to RBC membrane –> bite cells

G6PD deficiency

Question 14

Howell-Jolly bodies

Answer 14

Basophilic nuclear remnants found in RBCs.
Usu removed from RBCs by splenic macrophages.

Pts w functional hyposplenia or asplenia