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Peripheral blood smear in patient with thrombotic thrombocytopenic purpura. Typical schistocytes are annotated. A schistocyte or schizocyte (from Greek schistos for "divided" and kytos for "hollow" or "cell") is a fragmented part of a red blood cell. Schistocytes are typically irregularly shaped, jagged, and have two pointed ends. [1]
In some cases, a peripheral blood smear may show schistocytes, anisocytosis, polychromasia, or poikilocytosis. [7] Direct antiglobulin testing is the only way to confirm DIIHA. Direct antiglobulin testing can determine if complement C3 antibody and/or immunoglobulin G is bound to the red blood cell membrane. [4]
Microangiopathic hemolytic anemia may be suspected based on routine medical laboratory tests such as a CBC (complete blood cell count). Automated analysers (the machines that perform routine full blood counts in most hospitals) are designed to flag blood specimens that contain abnormal amounts of red blood cell fragments or schistocytes. [2]
Pappenheimer bodies (Peripheral Blood / May-Grünwald Giemsa and Prussian blue stain) Pappenheimer bodies are abnormal basophilic granules of iron found inside red blood cells on routine blood stain. [1] They are a type of inclusion body composed of ferritin aggregates, or mitochondria or phagosomes containing aggregated ferritin. They appear ...
The specific cause is dependent of the type of TMA that is presented, but the two main pathways that lead to TMA are external triggers of vascular injury, such as viruses, bacterial Shiga toxins or endotoxins, antibodies, and drugs; and congenital predisposing conditions, including decreased levels of tissue factors necessary for the coagulation cascade.
The peripheral blood smear may show fragmented red blood cells (known as schistocytes) due to shear stress from thrombi. However, this finding is neither sensitive nor specific for DIC; A diagnostic algorithm has been proposed by the International Society of Thrombosis and Haemostasis.
Modern complete blood count analyzers can provide an automated white blood cell differential, but they have a limited ability to differentiate immature and abnormal cells, so manual examination of the blood smear is frequently indicated. [5] [6] Blood smear examination is the preferred diagnostic method for certain parasitic infections, such as ...
Spherocytosis can be diagnosed in Peripheral blood film by seeing spherical red blood cells rather than biconcave. Because spherical red blood cells are more prone to lysis in water (because they lack some proteins in their cytoskeleton) there will be increased osmotic fragility on acidified glycerol lysis test. [citation needed]