II. Background

  1. Variants below as seen on Peripheral Smear
  2. RBC Evaluation parameters
    1. RBC Color
    2. RBC Size
    3. RBC Shape
    4. RBC Contents

III. Causes: Macrocytes

IV. Causes: Hypochromic Microcytes: Defective Hemoglobin synthesis

V. Causes: Spherocytes

  1. Hereditary spherocytosis
  2. Autoimmune Hemolytic Anemia
  3. Acute Alcoholism
  4. Hemoglobin C Disease
  5. Following severe Burn Injury
  6. Hemolytic transfusion reactions
  7. Severe Hypophosphatemia
  8. Acute Oxidant Injury: Hexose Monophosphate Shunt Defect
  9. Clostridium Welchii Septicemia

VI. Causes: Elliptocytes (Oval Cells)

  1. Megaloblastic Anemia
  2. Myelofibrosis
  3. Refractory normoblastic Anemia
  4. Hereditary elliptocytosis
  5. Thalassemia

VIII. Causes: Dacryocytes (tear drop RBC)

  1. Extramedullary hemopoiesis
  2. Myelophthisic Anemia
  3. Severe Hemolytic Anemia
  4. Erythroleukemia

IX. Causes: Acanthocytes (Spur Cells)

  1. Abetalipoproteinemia
  2. Cirrhosis
  3. Hepatic necrosis
  4. Pyruvate kinase deficiency
  5. Uremia
  6. Infantile pyknocytosis

X. Causes: Howell-Jolly Bodies

XI. Causes: Basophilic Stippling (aggregated ribosomes)

  1. Lead Poisoning
  2. Arsenic Poisoning
  3. Thalassemia
  4. Sideroblastic Anemia
  5. Hemolytic Anemia
  6. Severe Anemia
  7. Unstable Hemoglobin
  8. Pyrimidine 5'-Nucleotidase Deficiency

XII. Causes: Heinz Body (Aggregates of denatured Hemoglobin)

XIII. Causes: Target Cells

XIV. Causes: Sideroblasts

  1. See Sideroblastic Anemia
  2. Nucleated RBCs
  3. Iron laden mitochondria

XV. Causes: Cabot's Ring Bodies (Nuclear remnants)

XVI. Causes: Other findings on RBC exam

  1. Malaria
  2. Bartonella parasites

XVII. References

  1. Ravel (1995) Clinical Laboratory Medicine, p. 14-16

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Ontology: Acanthocytes (C0000886)

Definition (NCI) Erythrocytes with protoplasmic projections giving the cell a thorny appearance. (MeSH)
Definition (MSH) Erythrocytes with protoplasmic projections giving the cell a thorny appearance.
Concepts Cell (T025)
MSH D000050
SnomedCT 259685005, 250250008, 63599005
LNC LP17674-0, MTHU024320, LA11190-8
English Acanthocytes, cells spur, acanthocyte, acanthocytes, acanthrocyte, spur cell, Acanthocyte (morphologic abnormality), Spur cell (finding), Acanthocyte, Acanthrocyte, Crenated cell, Spur cell, Acanthocyte (cell), Spiny prickle cell, Acanthocyte [dup] (morphologic abnormality)
French Érythrocytes en anneaux, Acanthocytes, Acanthocyte
Swedish Akantocyter
Czech akantocyty
Finnish Piikkisolut
Latvian Akantocīti
Polish Akantocyty
Norwegian Akantocytter
Spanish acantocito [dup], acantocito (hallazgo), acantocito [dup] (anomalía morfológica), acantocito (anomalía morfológica), acantocito (célula), acantocito, Acantocitos
German Akanthozyten
Italian Acantociti
Dutch Acanthocyt, Acanthocyten
Portuguese Acantócitos

Ontology: Spherocytes (C0037888)

Definition (NCI) Small, abnormal spherical red blood cells with more than the normal amount of hemoglobin. (MeSH)
Definition (MSH) Small, abnormal spherical red blood cells with more than the normal amount of hemoglobin.
Concepts Cell (T025)
MSH D013102
SnomedCT 17235000, 259682008
LNC LP17717-7, MTHU024361, LA11212-0
French Sphérocytes, Sphérocyte
Swedish Sfärocyter
Czech sférocyty
Finnish Pallopunasolut
English Spherocytes, spherocytes, spherocyte, Spherocyte, Spherocyte (cell), Spherocyte (morphologic abnormality)
Latvian Sferocīti
Polish Sferocyty
Norwegian Sfærocytter
Spanish esferocito (anomalía morfológica), esferocito (célula), esferocito, Esferocitos
German Kugelzellen, Sphärozyten
Italian Sferociti
Dutch Kogelcel, Sferocyt, Sferocyten
Portuguese Esferócitos

Ontology: Dacryocyte (cell) (C0221266)

Concepts Cell (T025)
SnomedCT 47787007
LNC LP17677-3, MTHU024321
English Dacryocyte (cell), teardrop cells, tear drop cell, tear drop cells, dacrocytosis, teardrop cell, Dacryocytes, Tear drop cell, Dacryocyte, Teardrop cell, Dacryocyte (morphologic abnormality)
Spanish lacrimocitos, células lagrimales, eritrocito con forma de lágrima, dacriocito (anomalía morfológica), dacriocito (célula), dacriocito

Ontology: Elliptocyte (cell) (C0221280)

Concepts Cell (T025)
SnomedCT 45028007, 57882002
LNC LP17644-3, LP15192-5, LP14573-7, MTHU002587, MTHU001593, MTHU024229, LA11204-7, LA11199-9, LA11198-1
English Elliptocyte (cell), pencil cell, elliptocyte, ovalocytes, elliptocytes, pencil cells, ovalocyte, Elliptocytes, Pencil cells, Ovalocytes, Elliptocyte, Ovalocyte, Pencil cell, Pencil cell (cell), Elliptocyte (morphologic abnormality), Pencil cell (morphologic abnormality)
Spanish célula en lápiz (anomalía morfológica), célula en lápiz (célula), célula en lápiz, eliptocito (anomalía morfológica), eliptocito (célula), eliptocito, ovalocito

Ontology: Schistocyte (C0221282)

Concepts Cell (T025)
SnomedCT 142889005, 250245002, 142887007, 165480001, 70310009
LNC LP17715-1, LP14570-3, MTHU001590, MTHU017716, LA11209-6, LA11202-1
English Schistocyte, Schistocytes, cells fragmenting, helmet cells, schistocytes, schistocytosis, cells fragmented, helmet cell, schistocyte, Schistocytosis (finding), Helmet cell (finding), Schistocytosis, Helmet cells, Fragmented cell, Helmet cell, Schistocyte (cell), Schistocyte (morphologic abnormality)
Spanish eritrocitos con forma de yelmo, eritrocitos con forma de yelmo (hallazgo), célula en casco, célula fragmentada, esquistocito (anomalía morfológica), esquistocito (célula), esquistocitosis, esquistocito

Ontology: Sideroblast (C0229630)

Concepts Cell (T025)
SnomedCT 53838007
English sideroblast, sideroblasts, Sideroblast (cell), Sideroblast (body structure), Sideroblast
Spanish sideroblasto (célula), sideroblasto

Ontology: Macrocytic erythrocyte (C0333805)

Definition (NCI) An abnormally large red blood cell occurring mainly in anemias (as pernicious anemia), also called megalocyte. Lack of vitamin B12 and folic acid could also cause macrocytes. (NCI)
Concepts Cell (T025)
SnomedCT 259681001, 57457008
LNC LP17441-4, MTHU005229, LA11216-1
Spanish macrocito, eritrocito macrocítico (célula), eritrocito macrocítico, macrocito (anomalía morfológica)
English megalocytes, megalocyte, macrocytes, macrocyte, Macrocyte, Macrocytic erythrocyte (cell), Macrocyte (morphologic abnormality), Macrocytic erythrocyte, Macrocytes, Macrocytic Red Blood Cell

Ontology: Microcytic erythrocyte (cell) (C0369668)

Concepts Cell (T025)
SnomedCT 57457008, 397022008
LNC LP17463-8, MTHU005230, LA11218-7
English Microcytic erythrocyte (cell), microcyte, erythrocytes microcytic, microcytes, Microcyte (morphologic abnormality), Microcytes, Microcyte, Microcytic erythrocyte, Microcytic Red Blood Cell
Spanish microcito, microcito (anomalía morfológica), eritrocito microcítico (célula), eritrocito microcítico