Erythrocyte Abnormalities

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Erythrocyte Abnormalities

Clinical Pathology,

Ms. Canga

Erythrocyte Morphology

 Different species have different _________ RBCs with varying degrees of ___________________________.

 Dogs have _____________ RBCs (~________ µm in diameter)

 Cats, horses, cows, sheep, goats (3-4 µm)

 Llamas and camels have ______________________ (oval) RBCs

 Deer have _________________-shaped RBCs

 Birds, fish, amphibians, and reptiles have ______________________, elliptical RBCs.

 Human RBCs are about the same size as those of ______________.

Relative sizes of RBCs

Chicken Llama

Reptile Deer

Normal RBC Morphology

Feline blood. Normal erythrocyte morphology. Feline RBCs are smaller than dog erythrocytes, exhibit a slight amount of crenation, and have a minimal area of central pallor

Review

 There are 5 ways to classify erythrocytes as normal or abnormal:

 1) ________________________________________________

 2) ________________________________________________

 3) ________________________________________________

 4) ________________________________________________

 5) ________________________________________________

Arrangement on a Blood Film

 How should cells appear on film?

 Abnormal formation

 _____________________ formation

 _________________________________________

Rouleaux Formation

 Rouleaux formation

 Grouping of RBCs that appear ________________

 Normal in _________________

 Seen with increased _______________ or

___________________ concentration in blood

 May appear as an _________________

 Refrigerated blood not allowed to return to room temperature

 May be seen if blood has been held too long before preparation of smear

Rouleaux as an Artifact

 As you learned in Lab Pro, rouleaux formation may be an artifact.

 If it IS an artifact and not a true medical condition in the patient, ____________ may be added to the sample.

Rouleaux Formation

Agglutination/Auto-agglutination

 Agglutination is caused by an __________________ that coats the RBC causing bridging or clumping of the cells.

 Typically occurs in _________________________ disorders

 Agglutination MAY appear as __________________ on occasion

 To differentiate between agglutination and rouleaux, saline is added to the sample.

 On the next slide, are the EXACT procedures for adding saline to your sample:

Adding Saline to Confirm Rouleaux

 When rouleaux is suspected, ____________________ all tubes in question.

 Carefully remove ___________ /____________with transfer pipette, leaving the cells undisturbed. Discard/use plasma or serum

 Add 2 drops of ________________ to test tube and mix well.

 ________________________the tube

 Gently re-mix the red cells and perform smear

 _________________ will disperse,

______________________________will NOT

Comparison in the Monolayer

Agglutination can Affect WBCs too!

Variation in Color

 Called _______________________

 ____________________________

 ____________________________

 Calculated through the ___________ (Remember the formula?)

 Classifies cells as ____________________ or

_______________________

Polychromasia

 Variation in color usually associated with

__________ and ____________________

 ________ production begins right before cell loses nucleus

 ____________ intensity decreases as metabolic activity ____________________

 ________ increases in intensity as ________ production ______________________.

Polychromasia

 Recall that the _______________ the cell in the RBC maturation series, the more dark blue the staining due to increased __________________ activity.

 Mature RBCs stain _________ because they have their full complement of ________.

 ______ production begins right before cell loses

______________; immature RBCs with some Hb present stain ______________________ because there is still some metabolic activity going on within the cell.

Hypochromasia

 ____________ staining intensity of RBCs

 Caused by insufficient ________ concentration due to

_________ deficiency (Chronic ____________ loss or

______________________)

 Cell will appear normally stained around

__________________ with a much paler central region.

 Hypochromasia is almost always accompanied by

_____________________ . (Decreased __________)

 Determined by a decreased ______________

Hypochromasia

Hyperchromasia

 Increased staining intensity of RBCs

 Immature RBCs = larger and darker

 Hyperchromasia based on _______ concentration

(_______) cannot exist…

 Presence of _______________, ___________________, and _____________can interfere with tests and

_______________________ increase MCHC

 _____________________ often seen

 are __________________and __________________but can have normal cell volume. (Cell may be ________________)

 May be seen in mismatched _________________________

Hyperchromasia/Spherocytes

Canine blood. Regenerative anemia with spherocytes. Anisocytosis is due to macrocytic cells and spherocytes, which are smaller than normal and lack central pallor. Spherocytes are associated with hemolytic anemias due to immune disease or fragmentation. The polychromatophilic RBC with a rod- shaped area of central pallor (arrow) is a stomatocyte

Poikilocytosis

 Variations in the __________________ of RBCs

(poikil ~ irregular)

 Not a __________________________

 A general term to encompass nondescript variations in

______________ of erythrocytes that are scattered throughout the blood film.

Poikilocytosis

Note: Poikilocytosis, anisocytosis, and polychromasia are present on this slide.

Schistocytes “Helmet Cell”

 RBC fragments resulting from shearing of red blood cell by

_________________________________.

 May be seen with

_______________________________________ (DIC) or with

________________________

 Expect to also see ________________________________ on blood film of animals with DIC

 Can be caused by excess _______________deposition, malformation of _______________________, or excessive

_________________________in the blood

 Common name is “__________________________”

Schistocytes

Acanthocytes “Spur Cells”

 Have irregular membrane projections of _______________________ length and diameter with __________________________tips

 _______________________sized and spaced

 May be seen in blood smear of:

 Cats with _____________________________________,

 Dogs with ___________________disease or

 ____________________________of the liver

 Represent __________________ alteration rather than

________________________

 Commonly called “________________”

Acanthocytes

Echinocytes “Burr Cells

__________________ change

 Resulting from _____________ change in blood, altering cell

_____________________

 May appear __________________ or ruffled, with relatively

_____________ sized and spaced, short, _________ projections

 Associated with ____________ disease, ____________________ or rattlesnake _________________________in dogs

 Can be _____________________ if excess of _______ is present

Echinocyte formation

Echinocytes

Echinocytes as“Crenation”

 __________________ Change

 ______________________

 Slow ________________ of blood film

 _____________________EDTA tube

 Affects the ________________ of the cells on a blood film

Crenation

Drepanocytes “Sickle Cells”

 ________________________ with pointed ends

 Result of alteration in __________ due to low

___________ tension

 Normal finding in ___________, Angora _________, and some ___________

Drepanocytes

Keratocytes “Helmet cell”

 Also called “________________”

 Keratocytes are believed to result from

____________________________________

 Can also result from _________________ injury found with ___________ deficiency

 Presence of keratocytes has also been associated with ____________________,

_________________, ________________________, and various _________________ diseases.

Keratocytes and Pre-keratocytes

Anulocytes “Punched-out cells”

 ____________ shaped RBCs that form as a result of a loss of the membrane ____________________.

 Cell cannot return to normal shape after passing through a narrow _____________________.

 May be seen in any _______________ disease.

 Can also occur due to low _______ concentration or as an ____________________.

Anulocytes (Punched-out cells)

Dacryocyte “Teardrop cells”

 _________________ shaped RBCs with a single

____________________ or _______________end

 May be seen in _________________________ diseases or ____________ and ________________ disorders of dogs.

 Can be an ______________ . Check to see if the

_______________ are all pointing in the __________ direction.

Dacryocytes “Tear-drop Cells”

Eccentrocyte

 Characterized by a shifting of the _______________ to one side of the RBC

 ____________ portion of membrane is ragged and poorly

_______________________________.

 Form under conditions of ___________________ stress

 May be seen with ____________________________Anemia

Eccentrocyte

Codocytes (Leptocytes)

 Characterized by an increase in membrane

_________________ _________

 Include all of the following cells:

 __________________________

 __________________________

 __________________________

 __________________________

Target Cells (Bull’s eye Cell)

 Resembles a ____________ with a bulls-eye

 Have central area of _____________ surrounded by area of pallor

 _________________ of cell contains band of _______

 A few may be seen in _____________ smears

 May be associated with __________ deficiency, _________,

___________ diseases, and some _______________ disorders.

Target Cells

Folded cells and Stomatocytes

 Folded cells have a ______________ _____appearing central pallor

 _____________________ have a transverse, raised fold extending across the center of the cell and a clear, _________like pale region in the center.

 Both may be caused by a change in membrane _____________ associate with ______________ disease

 Both are considered an ___________________ if the areas of pallor are ________________________ to the feathered edge.

Stomatocyte

Stomatocytes

Folded Cells

Knizocytes (Barr Cells)

 Appear to have a bar of _________ through the central pallor.

 Commonly observed in chronic ______________ disease

 May be observed in any acute ______________ dysfunction

 Caused by an alteration in the ______________ content of cell membrane

Knizocytes or “Barr Cells”

Some Poikilocytes at a glance

Test yourself!

Presence of Structures on/in Erythrocyte

 Many different abnormalities caused by variety of different conditions.

 __________________________

 __________________________

 __________________________

 __________________________

 __________________________

 __________________________

 __________________________

 __________________________

 __________________________

Howell-Jolly bodies

 __________________________ nuclear remnants observed in young RBCs during their response to

__________________________ anemia

 Normally, as cells containing nuclear remnants pass through the

_______________ , _________________ cells remove the remnants.

 Therefore, HJBs may be seen with ________________ disease or in an animal with the _____________removed.

Howell-Jolly bodies

Basophilic Stippling

 Observed in RBCs that contain abnormal, residual ___________.

 Small, dark blue “__________________” within the RBC.

 Occasionally seen in __________________ RBCs in

_____________ cats.

 Characteristic finding with __________________________ in dogs.

Basophilic Stippling

Heinz Bodies

 Particles of __________________________, resulting from oxidative injury, attach to RBC _______________________.

 They stain blue with _________________________________ and appear as a _________________ area with Diff-quick stain.

 Seen in _________________________ and ______________ ingestion in cats and dogs

 HBs are often increased in concentration with diseases such as

_____________________ , ______________________, and

______________________________ in cats

 Normal cat blood may have up to _____%

Heinz bodies

Reticulocytes

 Immature RBC; contains _________________ (ribosomes) and residual RNA that are lost as the cell matures.

 A.k.a. ‘____________________________ RBC’ (when stained with _______________________ and not NMB)

 NMB causes visualization of clumping of residual organelles, referred to as ‘______________________’.

 Cats have two forms: ___________________ and

_____________________.

Reticulocytes

Canine Distemper Viral Inclusions

 Seen in RBCs of dogs with _________________.

 __________________________

 Variable in _________, __________, ________ and

_________(faint blue to magenta).

 More frequently seen in ________________________

RBCs than _______________RBCs.

 Can also be seen in ___________________ and

_____________________.

Viral Distemper inclusions

Blood Parasites that Affect RBCs

 Parasites may be present ____________ or _____ the surface of RBCs

 Stain ___________________ and drying

________________ are sometimes confused with RBC parasites.

Babesia spp.

 _____________________ or __________shaped,

______________________, paired inclusions

 Transmitted via ______________

 Causes ___________________ anemia

 Commonly identified at __________________ edge of blood smears

 Seen in __________, __________, __________, __________, and ______________

Babesia spp.

Mycoplasma haemofelis

 Formerly known as: ____________________________

 Disease = Feline Infectious __________________ Anemia

 May be, coccoid, rod-shaped, or ringlike structures, but usually appear as short, dark purple ________on the __________________ of RBCs

 Organisms usually detach from the RBC when placed in

_________________________.

 Cyclic ____________________, organisms may be numerous, scarce or not found in a given blood sample – examine blood at different

_____________of the day

 May be transmitted by ______________

Mycoplasma haemofelis

Mycoplasma haemocanis

 Formerly known as ___________________________

 Rare; Usually only occurs in

________________________ or immunosuppressed dogs.

 Organism appears as a chain or small cocci or rods that stretch across _____________ of RBC.

 Chains may appear “_____________________.”

Mycoplasma haemocanis

Cytauxzoon felis

 S mall, ring or _______________-shaped bodies in red cells

 Causes a ______________ disease in cats

 Transmission is by ____________

 Rare cause of _________________ anemia

 No known _________________

Cytauxzoon felis

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