Admin: /* Visible by normal staining */

2025-02-03T15:21:41Z

Visible by normal staining

← Older revision		Revision as of 11:21, 3 February 2025
Line 256:		Line 256:
	\|Howell-Jolly bodies		\|Howell-Jolly bodies
	\|		\|
	\|		\|DNA
	\|		\|
	\|		\|
Line 262:		Line 262:
	\|Pappenheimer bodies		\|Pappenheimer bodies
	\|		\|
	\|		\|Iron
	\|		\|
	\|		\|
Line 268:		Line 268:
	\|Basophillic stippling		\|Basophillic stippling
	\|		\|
	\|		\|RNA
	\|		\|
	\|		\|

Admin at 18:46, 2 February 2025

2025-02-02T18:46:53Z

Show changes

Admin: Created page with "{| class="wikitable" |+ !RBC Trait !Appearance !Physiology !Associated Conditions !Follow-up Testing |- |Rouleaux |Stacked formation ("stack of coins") in monolayer * Often seen with blue background staining | * Increased amount of plasma proteins * Excess protein have + charge that reduces RBC membrane charge (zeta potential) * Reduced charge allows cells to stack (due to biconcave shape) | * Multiple myeloma/plasma cell myeloma * Chronic liver disease * Lymphomas * Ac..."

2025-01-27T23:25:27Z

Created page with "{| class="wikitable" |+ !RBC Trait !Appearance !Physiology !Associated Conditions !Follow-up Testing |- |Rouleaux |Stacked formation ("stack of coins") in monolayer * Often seen with blue background staining | * Increased amount of plasma proteins * Excess protein have + charge that reduces RBC membrane charge (zeta potential) * Reduced charge allows cells to stack (due to biconcave shape) | * Multiple myeloma/plasma cell myeloma * Chronic liver disease * Lymphomas * Ac..."

New page

{| class="wikitable"
|+
!RBC Trait
!Appearance
!Physiology
!Associated Conditions
!Follow-up Testing
|-
|Rouleaux
|Stacked formation ("stack of coins") in monolayer

* Often seen with blue background staining
|
* Increased amount of plasma proteins
* Excess protein have + charge that reduces RBC membrane charge (zeta potential)
* Reduced charge allows cells to stack (due to biconcave shape)
|
* Multiple myeloma/plasma cell myeloma
* Chronic liver disease
* Lymphomas
* Acute and chronic inflammatory diseases (especially when plasma proteins like fibrinogen or globulins are increased)
|Saline replacement to remove excess protein
|-
|Agglutination
|Irregular clumping of cells in monolayer
|
* Caused by IgM antibodies (cold agglutinins)
* Large antibodies can span zeta potential gaps and form lattice with other antibody-coated cells
* IgMs bind to RBCs at room temperature
|
* Cold autoimmune hemolytic anemia
* IgM-associated lymphomas
* Multiple myeloma
* Paroxysmal cold hemoglobinuria
|Pre-warm sample to 37C to dissociate cold IgMs
|-
|Microcytosis
|Smaller cells (round, biconcave)
|
* More divisions causing smaller cells
* Hemoglobin errors - cells continue dividing to reach adequate hemoglobin concentrations
|
* Thalassemia (small, uniform size - N RDW)
* IDA (small, varying size - ↑ RDW)
* Anemia of chronic inflammation
* Lead poisoning
* Hemoglobinopathies
* Sideroblastic anemia
|
|-
| rowspan="2" |Macrocytosis
|Round macrocytes (size)
|
* Increases in cell membrane size (more cholesterol)
* Retain shape, but with larger membrane
|Moderate ↑ MCV

* Liver disease
* Normal neonate
* Reticulocytosis
|
|-
|Oval macrocytes (shape)
|
* Fewer divisions causing larger cells - errors in DNA synthesis
* Cytoplasm increases, but DNA doesn't (asynchrony)
|Marked ↑ MCV

* Megaloblastic anemia (B12/folate deficiency)
|
|-
|Hypochromasia
|Cells >1/3 central pallor

* 1/2-2/3 moderate
* >3/4 marked
* Consistent field-to-field, gradual colour change
|
* Decreased or abnormal hemoglobin
|
* IDA
* Thalassemias
* Sideroblastic anemia
* Lead poisoning
* Some anemia of chronic inflammation
|↓ MCH, ↓ MCHC
|-
|Increased polychromasia
|Larger, irregular bluish cells, without central pallor
|
* Cells at final stage of RBC maturation
* Have lost nucleus but have not assumed final biconcave shape
* Increase indicates bone marrow response to push out immature cells (compensatory mechanism)
|
* 0.5-2.5% normal in adults
* Increased in conditions causing RBC damage or destruction
|Reticulocyte count

* Manual supravital staining (methylene blue to visualize RNA)
* Automated immature reticulocyte fraction (IRF) to stain nucleic acids
|-
|
|
|
|
|
|-
|
|
|
|
|
|}
Combinations
{| class="wikitable"
|+
!
!
!
!
|-
|Dual Population
|Usually normal population with abnormal population
|
* Condition being treated (newer, healthy population)
* Condition plus blood transfusion
|
|-
|Normocytic/normochromic
|Normal size and colour of RBC
|
* Normal patient
* Anemia from reduced RBC numbers (hemorrhage, burns, etc.)
|
|-
|Hypochromic/microcytic
|Small cells with large central pallor
|
* Anemia from abnormal hemoglobin production or metabolism (e.g., IDA)
|
|}
RBC Metabolism

RBC Breakdown

Extravascular Hemolysis (Macrophage-Mediated Hemolysis)

* Occurs in spleen, primarily due to splenic macrophages
* Slower movement through splenic sinusoids allows older or damaged cells to be destroyed
* RBC contents salvaged and metabolized
** Hemoglobin broken down into globin chains and iron
**
* Most (90%) of RBCs are destroyed this way

Intravascular Hemolysis (Fragmentation/Mechanical Hemolysis)

* Occurs inside blood vessels
* Mechanical damage to cells causing hemolysis
** Can also be caused by damage to blood vessels (e.g., clots)
* RBC contents also salvaged
** Hemoglobin binds to transport proteins (primarily haptoglobin when available, if hemoglobin oxidizes then binds to hemopexin)
** Taken to liver (hemoglobin) or excreted by kidney
* Less common (10-20%) method of RBC destruction

Red Blood Cell Morphology - Revision history

Admin: /* Visible by normal staining */

Admin at 18:46, 2 February 2025