By Irma Pereira MT (ASCP) SH, Tracy I. George MD, Daniel A. Arber MD
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Extra resources for Atlas of Peripheral Blood: The Primary Diagnostic Tool
Heat-associated and Other Traumatic Anemias Exposure to extremely high temperatures can damage the RBC membrane leading to significant variability in red cell size and shape (Fig. 5). Splenomegaly or hypersplenism is another factor that can induce mechanical destruction of RBCs leading to normocytic normochromic anemia. Leukocytes and platelets may also decrease in number secondary to sequestration, resulting in additional cytopenias. INTRACORPUSCULAR Oxidative Hemolytic Anemia Glucose-6-phosphate dehydrogenase (G6PD) and pyruvate kinase (PK) deficiencies are the two most common hereditary RBC enzyme disorders that can cause hemolytic anemia (Fig.
5). , IgM antibodies also known as cold agglutinins). Rouleaux or “stacking” of three or more RBCs is due to high protein states such as multiple myeloma or polyclonal hypergammaglobulinemia. 6. RBC Hemoglobin Concentration: Normal RBCs have central pallor that occupies approximately one-third of the cell. 7. Poikilocytosis: Some degree of poikilocytosis (variation in RBC shape) can be seen on normal adult blood smears. This poikilocytosis usually occurs from a mix of cells types. 8). Based on the percentage of high- or lowfrequency cells in the blood, the degree of poikilocytosis can be graded.
Beta thalassemia trait (or minor) is characterized by one b globin gene being affected, resulting in an asymptomatic state with a mild microcytic anemia. Varying numbers of target cells, dacrocytes, and basophilic stippling are present on the peripheral blood smear (Fig. 8). 5%). If two b globin genes are affected, this is known as beta thalassemia major (or Cooley anemia), which is a severe microcytic hypochromic anemia usually resulting in death by the end of the second decade of life if untreated.