Identification of Normal and Abnormal Forms of Red
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IDENTIFICATION OF NORMAL AND ABNORMAL FORMS OF RED BLOOD CELLS
Prepared by: Miss. Nada Alzahrani
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Erythrocytes (RBCs)
The normal RBCs are biconcave discs, anucleate, essentially no organelles
Filled with hemoglobin (Hb), a protein that functions in O2 and Co2 transport
Contain the plasma membrane protein spectrin and other proteins that: Give erythrocytes their flexibility Allow them to change shape as necessary
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Erythrocytes (RBCs)
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The Morphological classification
The morphological classification of RBC is
based on:
red cell size.
red cell shape.
haemoglobin content of RBC.
red cell with inclusions.
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1. Red Cell Size:
Red Cell Size:
1. microcytes: MCV < 80 fL
2. normocytes: MCV = (80 – 98) fL
3. macrocytes: MCV > 98 fL
4. anisocytosis: variation in red
cell size.
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Haemoglobin Content of RBC
Haemoglobin Content of RBC : 1. Hypochromic cell: reduced
staining of erythrocytes. 2. Normochromic cell: normally
staining (of a red cell). 3. Polychromatic cell: an erythrocyte
with a blue tinge to the cytoplasm, indicating
that it is a young red cell.
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The Morphological classification
Red cell size and haemoglobin content are
classified into 3 types:
I. Microcytic, hypochromic
II. Normocytic, normochromic
III. Macrocytic, polychromatic
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Microcytic Hypochromic
Causes:
Iron deficiency anemia
Thalassemia minor
Anemia of chronic disease
Congenital sideroblastic anemia
ß-Thalassemia intermedia and major
Hemoglobin H or E disease
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Microcytic Hypochromic
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Normocytic Normochromic
Causes :
Anemia of chronic disease
Early iron deficiency
Renal failure
Aplastic anemia
Leukemia
Lymphoma
Cancer
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Macrocytic Polychromatic
The RBC are almost as large as the lymphocyte.
Causes:
Megaloblastic anemia.
Alcoholism
Liver disease
Reticulocytosis
Chemotherapy
Multiple myeloma
Hypothyroidism
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Macrocytic Hypochromic
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Red Cell Shape
1.Acanthocytes
Cells with irregular, thorny
speculated membrane
surface projections bulbous
round ends.
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Red Cell Shape
2. Ecchinocytes:
Cells with 10-30
uniformly distributed
spicules.
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Red Cell Shape
3. Elliptocytes:
Red blood cells
that are oval or
cigar shaped.
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Red Cell Shape
4.Spherocytes,:
Spherocytes are almost spherical in shape. They are not biconcave like a normal red blood cell and do not have the central area of pallor which a normal red cell shows.
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Red Cell Shape
5. Target cells:
are abnormally thin erythrocytes that when stained show a dark central color spot in the area of pallor and a peripheral ring of hemoglobin, separated by a pale unstained ring containing less hemoglobin.
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Red Cell Shape
6. Tear Drop cells:
An abnormal erythrocyte shaped like a teardrop.
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Red Cell Shape
7. Stomatocytes
cells are cup shaped with an abnormal area of central pallor that may be oval, elongated, or slit like
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Red Cell Shape
8. Sickle Cells
Cells have a sickle with appoint at one end.
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Red Cell Shape
9. Schistocytes :
are red blood cell fragments that result from membrane damage encountered during passage through vessels.
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Red Cell Shape
10. Rouleaux
formation:
Occurs when
RBCs form
stacks or
rolls.
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Red Cell Shape
11. Poikilocyte :
an abnormally shaped erythrocyte.
(increased variability in the shape of erythrocytes).
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Red Cell with Inclusions
Red Cell with Inclusions:
1. Basophilic stippling. 2. Heinz bodies 3. Howell jolly body 4. Nucleated RBC 5. Malaria parasites 6. Reticulocyte.
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Red Cell with Inclusions
1. Basophilic stippling:
The presence of evenly dispersed purplish blue dots in the cytoplasm of erythrocytes.
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Red Cell with Inclusions
2. Heinz bodies :
are denatured particles of haemoglobin attached to RBC membrane that appear when stained with cresyl blue or methyl violet.
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Red Cell with Inclusions
3. Howell jolly body :
are nuclear fragment found in red cells, mostly single but sometimes multiple.
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Red Cell with Inclusions
4. Nucleated RBC:
The
erythroblasts
in the
circulating
blood
(immature red
cells).
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Red Cell with Inclusions
5. Malaria
parasites:
1. P. falciparum
2. P. vivax
3. P. ovale
4. P. malaria
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Red Cell with Inclusions
6. Reticulocyte:
a young erythrocyte, newly released form the bone marrow, identified by its uptake of certain vital stains such as new methylene blue.
Reticulocyte
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Blood Smear Interpretation:
A) Normal
B) Micro/hypo
C) Macro
D) Target
E) Sphero
F) Heinz body
G) Schistocyte
H) nRBC
I) Polychrom
J) Teardrop
A B C D
E F G H
I J
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Thank you