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Reversible: oat cell-shaped Sickle Cells Mutations in People with this disorder have atypical N/A
Irreversible: Crescent shaped with the HBB gene hemoglobin molecules called hemoglobin S
pointed projections at one or both cause sickle cell
ends. disease.
split, cut, or cloven cells Fragmented Cells- trauma to the cell microangiopathic hemolytic anemia N/A
Schistocytes membrane. disseminated intravascular coagulation (DIC)
heart valve surgery
hemolytic uremic syndrome
thrombotic thrombocytopenic purpura
renal graft rejection, vasculitis
severe burn
march hemoglobinuria (a form of
hemoglobinuria seen in soldiers and long-
distance runners).
blister cells. pocket-book Fragmented Cells- Keratocytes are red disseminated intravascular coagulation (DIC) N/A
cells. “horned” cells Keratocytes cells that have been
(keras=horn) caught on fibrin
strands in
circulation, and
rather than
splitting, the cell
hangs over the
fibrin fusing two
sides of the cell
together, creating a
vacuole.
Cells with 3-12 spicules of uneven Acanthocytes N/A myeloproliferative disorders Decreased MCV
length distributed along the periphery microangiopathic Normal MCHC
of the cell membrane. hemolytic anemia (MAHA) Increase MCV
The uneven projections are blunt. autoimmune hemolytic anemias.
Alcohol intoxication (Zieve’s syndrome)
Pyruvate kinase deficiency
Congenital abetalipoproteinemia
Vitamin E deficiency
Postsplenectomy
Tear-shaped Teardrop Cells As cells containing thalassemia syndromes Decreased, normal,
large inclusions drug-induced Heinz body formation increased MCV
attempt to pass iron deficiency
through the in conditions in which inclusion bodies are
microcirculation, formed
the portion of the megaloblastic processes as large tear-shaped
cells containing the cells (macroteardrops).
inclusion cannot Myelophthisic anemia
pass through and
consequently gets
pinched, leaving a
tailed end.
Stacks of coins Rouleaux Elevated globulins Hyperpoteinemias: multiple myeloma and N/A
Formation or fibrinogen in the Waldenstrom’s macroglobulinemia.
plasma. Chronic inflammatory disorders
Lymphomas
Artifact
Random clusters RBC Antigen-antibody Cold antibody syndromes: cold MCHC: falsely elevated
agglutionation reaction. hemagglutination disease and paroxysmal cold MCV: falsely elevated
Auto agglutination: hemoglobinuria (PCH)
patient’s own Hemolytic anemia
cells react with Atypical pneumonia
serum or plasma. Staphylococcal infections
Trypanosomiasis
Artifact