6: Erythrocyte Shapes/Inclusions/Infective Agents

anisocytosis

variation in RBC size

poikilocytosis

abnormally shaped RBCs

macrocytosis

increased RBC size

microcytosis

decreased RBC size

polychromasia

increased blue color of RBCs on stain (immature reticulocytes)

reticulocyte

immature RBC

if we see a polychromatophilic RBC, what do we call it?

reticulocyte

what species is it NORMAL to see poikiloytes?

goats, young healthy cattle

drepanocytes (sickle cells)

spindle-shaped cells, normal in deer

rouleaux

stacking of RBCs (like coins)

rouleaux present in a dog. what should we suspect?

hyperglobulinemeia

agglutination present in a dog. what should we suspect?

immune-mediated hemolytic anemia (IMHA)

agglutination

saline treatment of RBCs, still stick together

echinocytes

spiny cells, common in pigs

echinocytes are present in a dog. what should we suspect?

snake bites, uremia, glomerulonephritis, neoplasia, doxorubicin

echinocytes are present in a horse. what should we suspect?

total-cation depletion

what promotes echinocytes?

RBC dehydration, ATP depletion, increased pH/RBC Ca

acanthocytes

caused by excess cholesterol

ancanthocytes are present in a dog. what should we suspect?

liver disease, hemangiosarcoma, glomerulonephritis, DIC

stomatocytes

swollen/folded RBCs

stomatocytes are present on histology. how does this show up on bloodwork?

increased MCV, decreases MCHC

spherocytes

smaller, sphere-shaped RBCs, cause from cell membrane loss

MCV can be high in patients with immune-mediated hemolytic anemia. WHY?

reticulocytes have high cell volumes

schistocytes

fragmented RBCs

what causes RBC fragmentation?

mechanical injury, DIC, HWs, glomerulonephritis

endothelial injuries causing RBC fragmentation in dogs

hemangiosarcoma, vasculitis, splenic/hepatic disease

thermal injuries causing RBC fragmentation

heat stroke/severe burns

eccentrocytes

Hemoglobin pushed to one side

eccentrocytes are present in a dog. what DISEASES can cause this?

diabetes, inflammation, neoplasia

eccentrocytes are present in a dog. what TOXIC AGENTS can cause this?

onions, garlic, NSAIDS, propofol, vitamin K

what diseases may cause MULTIPLE RBC shape abnormalities?

liver disease, hemangiosarcoma, glomerulonephritis, DIC, chronic Fe defiency anemia

nucleated RBCs

rubricytes/metarubricytes

nucleated RBCs are present. IN GENERAL what should we suspect?

REGENERATIVE anemias, lead toxicity, heat stroke, bone marrow injury/disease, splenic dysfunction

nucleated RBCs are present in a dog. what should we suspect IN ADDITION to the general causes?

CV disease, inflammation, trauma, hyperadrenocorticism

nucleated RBCs are present in a cat. what should we suspect IN ADDITION to the general causes?

hepatic lipidosis, acute trauma, inflammation

what causes marrow injuries WITHOUT ANEMIA

sepsis, shock, drugs, heat stroke

marrow diseases causing NON-REGENERATIVE ANEMIA

myelodysplasia, hematopoietic neoplasia

howell-jolly bodies

nuclear remnants in RBCs

what can cause an increase in howell-jolly bodies?

REGENERATIVE anemia, splenectomy, glucocorticoids

heinz bodies

oxidized/denatured hemoglobin inclusions

what can cause an increase in Heinz bodies?

diabetes, lymphoma, hyperthyroidism, splenectomy

basophilic stippling of RBCs are present. what is going on?

REGENERATIVE ANEMIA or lead poisoning

infectious agents of RBCs

protozoa, mycoplasma, bacteria, viruses

protozoa affecting RBCs

babesia, theileria, cytauxzoon

rickettsial organism affecting RBCs

anaplasma

mycoplasma organism affecting RBCs

hemotropic mycoplasmas

what bacteria can affect RBCs?

bartonella

what virus can affect RBCs?

distemper

true or false: Rouleaux DISAPPEARS in saline, while agglutination persists

TRUE

strongest evidence of RBC fragmentation

schistocytes

what cell type is seen in IMHA, especially in dogs?

spherocytes

IMHA

immune mediated hemolytic anemia

basophilic stippling of RBCs. what is it?

aggregates of ribosomes