Is there agglutination or rouleaux?Ī list of RBC morphologies, their definitions, and their associated clinical states is shown in Table 1 3. Are there Howell–Jolly bodies, malaria parasites, nucleated RBCs, etc.? Is there hypo- or hyperchromasia? Is there anisochromia or polychromasia? Is there anisocytosis or a dual population? For example, a high platelet count is expected in anemia due to iron deficiency and a low platelet count is expected in anemia due to microangiopathic hemolysis. To review relevant white blood cell (WBC) and platelet (PLT) findings.microcytosis due to the blood counter's misidentification of giant platelets as RBCs.macrocytosis due to RBC agglutination or rouleaux, hyperleukocytosis, or severe hyperglycemia.low counts due to faulty aspiration of whole blood by the automated counter.It is unusual for laboratory error to affect any of the measurements in the CBC, but spurious findings may include the following 1, 2: When used properly, RBC morphology can be a key tool for laboratory hematology professionals to recommend appropriate clinical and laboratory follow-up and to select the best tests for definitive diagnosis. Like all laboratory tests, RBC morphologies must be interpreted with caution, particularly in infants and children.
In macrocytic anemias, RBC morphology can help guide the diagnostic considerations to either megaloblastic or nonmegaloblastic causes. In normocytic anemias, morphology can assist in differentiating among blood loss, marrow failure, and hemolysis-and in hemolysis, RBC findings can suggest specific etiologies. In patients with microcytic anemia, RBC morphology can increase or decrease the diagnostic likelihood of thalassemia. Abnormalities of RBC shape and other RBC features can provide key information in establishing a differential diagnosis. These include assessment of RBC shape, size, color, inclusions, and arrangement. In patients with anemia, the peripheral smear permits interpretation of diagnostically significant red blood cell (RBC) findings. The foundation of laboratory hematologic diagnosis is the complete blood count and review of the peripheral smear.
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