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Schistocytes compared to other forms of poikilocytosis. Schistocytes are fragmented red blood cells that can take on different shapes. They can be found as triangular, helmet shaped, or comma shaped with pointed edges. Schistocytes are most often found to be microcytic with no area of central pallor.
In diseases such as hemolytic uremic syndrome, disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, and malignant hypertension, the endothelial layer of small vessels is damaged with resulting fibrin deposition and platelet aggregation.
Microcytic anemia is not caused by reduced DNA synthesis [citation needed]. Thalassemia can cause microcytosis. Depending upon how the terms are being defined, thalassemia can be considered a cause of microcytic anemia, or it can be considered a cause of microcytosis but not a cause of microcytic anemia.
[7] [18] [28] Early signs of systemic complement-mediated TMA include thrombocytopenia (platelet count below 150,000 or a decrease from baseline of at least 25%) [16] and evidence of microangiopathic hemolysis, which is characterized by elevated LDH levels, decreased haptoglobin, decreased hemoglobin, and/or the presence of schistocytes.
Lead poisoning resulting from the environment causes non-immune hemolytic anemia. [20] Similarly, poisoning by arsine or stibine also causes hemolytic anemia. [21] Runners can develop hemolytic anemia due to "footstrike hemolysis", owing to the destruction of red blood cells in feet at foot impact. [22] [23]
Microcytic anaemia; Microcytosis is the presence of red cells that are smaller than normal. Normal adult red cell has a diameter of 7.2 µm. Microcytes are common seen in with hypochromia in iron-deficiency anaemia, thalassaemia trait, congenital sideroblastic anaemia and sometimes in anaemia of chronic diseases.
or a mixture of conditions producing microcytic and macrocytic anemia. [1] Blood loss, suppressed production of RBCs or hemolysis represent most cases of normocytic anemia. In blood loss, morphologic findings are generally unremarkable, except after 12 to 24 hrs where polychromasia appears.
In some cases, a peripheral blood smear may show schistocytes, anisocytosis, polychromasia, or poikilocytosis. [7] Direct antiglobulin testing is the only way to confirm DIIHA. Direct antiglobulin testing can determine if complement C3 antibody and/or immunoglobulin G is bound to the red blood cell membrane. [4]