Abnormalities in Erythrocytes

Laboratory Procedures

Red Blood Cells:aka ___________

______________is the process of maturation of a RBC

Formed by the stem cell through action of the _________________________called ___________(EPO)

Maturation of a RBC takes about 5 days.

Erythrocyte Life Span Stem Cell → _________________→ Prorubricyte

→ ___________________→ Metarubricyte→ ________________________→ RBC

Metarubricyte- nucleated RBC released in severe anemia.

Erythrocyte Life Spans Dog ~________ days Cat ~_______ days Cow ~ 160 days Horse ~ 145 days Man ~ 120 days Mouse ~ 30 days

RBC’s continued No _______________

____________ varies among species

Canine Erythrocytes

Feline Erythrocytes

Classification of RBC’s

RBC’s are classified the following criteria:◦ 1) Cell _________________ on blood film◦ 2) __________◦ 3) __________◦ 4) __________◦ 5) Presence of ___________ on erythrocytes (We will

come back to this one!)

Classification of RBC’s1) Cell Arrangement on Blood Film

Normal erythrocytes should lie in a nice, even, __________ layer on the _____________-most edge of a blood film

Rouleaux Formation Defined:____________________________________

____________. ◦ It can be a sign of increased fibrinogen or globulin

concentration◦ Can be an _______seen in blood that is held too

long before preparation of blood slide or if refrigerated.

◦ If a drop of _______ is added to blood, rouleaux will disperse

Rouleaux formation

AgglutinationOr Auto-agglutination May appear as rouleaux (stacks) or in

clusters Occurs in ______________disorders An ______________ coats the cell causing

bridging or clumping. If a drop of _____________ is added to blood,

agglutination will not disperse

Agglutination

Classification of Blood Cells◦2) Color of Erythrocyte

Erythrocytes that are normally colored are called _______________________________

Polychromasia: ______________________________ Polychromasia can appear as

______chromasia or _____chromasia.

Can exist as ________________________ or ________________________.

Polychromatic erythrocytes exhibit a ____________ tint. This is caused by a small amount of ______________ retained in the cytoplasm. These may appear as a ________________________________________. (We will talk about these later in this presentation.)

Polychromasia

Is a __________________ in color, due to a decreased staining intensity caused by insufficient ________________________ within the cell.

Most commonly caused by __________________________________

Hypochromasia

Polychromasia

Hypochromasia

Refers to a cell that appears _____________ than normal cells. This gives the appearance that the cell is over-saturated with _______________________.

TRUE hyperchromasia cannot exist! Each erythrocyte has a

____________________________________________ for hemoglobin and over-saturation cannot occur

If cells appear hyperchromic, there is another underlying concern.

Hyperchromasia

Hyperchromasia

Stands for:______________________________________________

Describes cells as normochromic or hypochromic (why no hyperchromic?)

Normal MCHC is 31-36% (You will learn this calculation in Clin. Path)

MCHC

Erythrocytes that are of normal, consistent size are called ___________________________________

Anisocytosis: _______________________________ ___________________ cells are smaller than

normal cells ___________________ cells are larger than normal

cells

Classification of RBC:3) Size of Erythrocyte

Variations in ___________________

Can indicate ___________________

Classified by ____________________ OR _____________________

Anisocytosis

Anisocytosis

Simply means that there are an abnormal amount of cells _____________________ than normal size.

Can indicate __________________ disease or _____________________ deficiency.

Macrocytosis

Macrocytosis (left) vs- Normocytes

Indicates that there is an abnormal amount of cells that are ___________________ than normal.

Can indicate _______________ deficiency.

Microcytosis

Stands for ____________________________________________

Describes cells as being ____________________, ___________________, or _____________________.

Measures the average volume of RBC’s.

Normal values are 66-77 fL (femtolitres)

MCV

Poikilocytosis: ______________________________

This is an “________________________” term that cannot suggest a ______________________

Classification of RBC’s4) Shape of Erythrocyte

Is a major deviation in the normal ____________ of the erythrocyte.

Remember that this term is an umbrella term for abnormally ________________ erythrocytes, and should not be used as a _______________.

Poikilocytosis

All of the following cells are under the “umbrella” of Poikilocytes. They just have different names!

(Remember rule #2)

Many Poikilocytes

Schistocytes (Fragmented Cells)

RBC’s with abnormal shape. Formed as a result of shearing of the cell by

_______strands. This occurs when red blood cells rapidly pass through microvasculature that is lined or meshed with strands.

They are observed in fragmentation hemolysis caused by _______________, ________________, ______________, and possibly ________________________anemia.

Schistocytes

Acanthocytes (Spur Cells)

The term acanthocyte is derived from the Greek word “acanthi” meaning “thorn” Acanthocytes are cells with five to ten irregular, blunt, finger-like projections.

The projections with vary in ______, __________ ,and surface ____________________.

These cells are seen in animals with altered ________________metabolism such as cats with _______________________________ or dogs with ______________ disease.

Acanthocytes Continued

Echinocytes (Burr Cell) Echinocytes have multiple, small, delicate

regular shaped spines _______________________________ around the cell and are indistinguishable from artificially ___________________cells.

Echinocytes Continued

Echinocyte formation can be ___________________, often seen with slow drying blood films or if the EDTA tube was ______________. This artifact is then termed ____________________.

Echinocytes have been associated with _______________disease, lymphosarcoma and rattlesnake bites in dogs.

They can been seen after exercise in ________________.

Crenation Identified as the presence of many

__________ membrane projections involving most RBC’s.

It is usually an ___________due to slow drying of the blood film.

Commonly observed in ___________blood but can be seen in any species.

Drepanocytes (Sickle cell)

These cells are _________________ shaped with pointed ends.

Drepanocytes are often seen in normal blood of __________and ________________.

It is thought to be a result of low _______________tension.

Drepanocytes

Pre-keratocytes Cells with ____________________are called

_______________cells or pre-keratocytes.

Keratocyte (Helmet Cells) Also called ___________cells. Keratocytes are

associated with trauma especially cellular damage from contact with ________________strands.

Spherocytes Cells have a spheroid shape instead of

the usual biconcave disk shape. Have ______________cell membrane and

are ___________________________. Seen most frequently in_______________

_________________________________(AIHA).

Usually seen in _______.

Dacryocytes (tear drop cells)

These tear drop shaped cells are seen in _____________________________diseases.

These cells, when produced as an ______________can be identified by the direction of their tail.

Dacryocytes produced as an artifact have their tails pointing in ___________________________________________.

Is an “___________ term” describing cells that are characterized by an increase in membrane ___________________________.

Include the following:◦ ________________________________◦ ________________________________

Codocytes (aka Leptocytes)

Folded Cells and Stomatocytes The appearance of Folded cells with their

_____________________________central pallor has been compared to a fish mouth and a coin slot.

Stomatocytes resemble a ____________________

Both are associated with a hereditary condition but are also seen in ____________disease, acute alcoholism (humans), and ________________imbalances.

Folded Cells

Stomatocytes

Target Cells Observed mainly in _______________.

Represent cells with an ____________________ membrane-to-volume ratio not specific to any disease.

The ________________________________is thin and flimsy.

Target Cells (Bull’s Eye Cells) Thin, bell-shaped cells

Centrally stained area

Can indicate ____________disease or hemoglobinopathies.

May be seen as________________when smearsmade in high ______________ or if ______________ dry.

Target Cells

nRBC Basophilic Stippling Howell Jolly Bodies Heinz Bodies Reticulocytes

Structures Present on/in Erythrocytes

Nucleated Red Blood Cells (NRBC’s)

Nucleated red blood cells (NRBC) usually represent early release of _________________red blood cells during ____________.

These are nuclear remnants seen in young erythrocytes during a response to anemia.

Basophilic Stippling Observed in RBC’s that contain abnormal

aggregation of __________. Can be observed in cases of

_____________________poisoning, with non-regenerative ______________or intense _______________________in dogs, cats, and ruminants.

Howell-Jolly Bodies ___________________remnants observed in young

erythrocytes. Often observed in ________and __________. Can be seen in __________________anemic

animals. Also may be seen with ____________disease or in

an animal with the ________________removed.

Heinz Bodies Particles of denature ________________protein. They stain with new methylene blue and

appear as ________________________ with quick stain.

May be caused by certain drugs and chemicals. Also associated with __________ or ____________toxicity in dogs!

Normal __________blood may have 2-3%. ___________recognizes as abnormal and starts to

lyse the cells.

Heinz Bodies

More Heinz Bodies

Reticulocytes These are immature red blood cells that

contain _____________(ribosomes) that are lost in the mature cell. Cats have two forms of reticulocytes. ◦ The _______________ form contains large clumps of

reticulum. They mature into the _____________form within _____hours.

◦ The _______________form, unique to ________, contains two to eight singular granules. Punctate reticulocytes circulate for ___________days before the all the ________________are lost.

Reticulocytes in the Peripheral Blood

Non-nucleated cell containing RNA which can be easily seen when stained with methylene blue.

Hallmark of erythrocyte ___________________response.