Which of the following red cell abnormalities is most indicative of hemolysis?
A. Target cellsB.Acanthocytes
C. Schistocytes
D. Basophilic stippling
The
answer is c.
Abnormalities of red cells can help to identify a disease process.
Schistocytes, which are red cell fragments, indicate the presence of hemolysis,
and they can occur in hemolytic anemia, megaloblastic anemia, or severe burns.
Red cell shapes characteristic of hemolysis include triangular cells and helmet
cells. Target cells (red cells with a central dark area) are the result of
excess cytoplasmic membrane material and are found in patients with liver
disease, such as obstructive jaundice, or in any of the hypochromic anemias.
Acanthocytes are irregularly spiculated red cells found in patients with
abetalipoproteinemia or liver disease. Echinocytes, in contrast, have regular
spicules (undulations) and may either be artifacts (crenated cells) or be found
in hyperosmolar diseases such as uremia. Basophilic stippling of red cells
(irregular basophilic granules within erythrocytes) varies from fine granules,
seen in young reticulocytes (polychromatophilic cells), to coarse granules seen
in diseases with impaired hemoglobin synthesis, such as lead poisoning and
megaloblastic anemia. Heinz bodies are formed by denatured hemoglobin and are
not seen with routine stains. They are found in patients with
glucose-6-phosphatase dehydrogenase deficiency and the unstable hemoglobinopathies.
