By Irma Pereira MT (ASCP) SH, Tracy I. George MD, Daniel A. Arber MD
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Extra info for Atlas of Peripheral Blood: The Primary Diagnostic Tool
Poikilocytosis: Some degree of poikilocytosis (variation in RBC shape) can be seen on normal adult blood smears. This poikilocytosis usually occurs from a mix of cells types. 8). Based on the percentage of high- or lowfrequency cells in the blood, the degree of poikilocytosis can be graded. 9). 10 highlights distinct red cell abnormalities and their associated disorders. Central pallor >1/2 but <2/3 of RBC. Pale outer rim of hemoglobin. Moderate Central pallor >2/3 of cell. Pale outer rim of hemoglobin.
In hereditary spherocytosis, the RBCs are more sensitive to progressively hypotonic solutions and therefore, exhibit earlier hemolysis, resulting in a positive osmotic fragility test (Fig. 14). 8 Heinz bodies highlighted by methylene blue stain show up as dark blue inclusions in erythrocytes. 9 Mechanism of spherocyte formation in Heinz body anemia. mainly contributes to hemolytic anemia. Thus, splenectomy mitigates hemolysis. Hereditary Elliptocytosis Syndromes Hereditary elliptocytosis (HE) is a fairly common disorder with an estimated incidence of 1 in 2000 to 4000 individuals.
6). G6PD deficiency: This is the most common RBC enzyme deficiency affecting more than 400 million people. The incidence is highest in Africans, people of Mediterranean descent, and Southeast Asians. 2 A: A remarkable number of schistocytes are present in this patient with microangiopathic hemolytic anemia due to hemolytic uremic syndrome. Note the absence of platelets. B: In this patient with toxic shock syndrome, the neutrophil at bottom contains numerous toxic granulations. At top, an immature granulocyte with vacuolated cytoplasm and toxic granulation is present.