RED BLOOD CELL DISORDER
ANISOCYTOSIS:
Anisocytosis is the medical term for having red blood cells (RBCs) that are unequal in
size. Normally, RBCs should all be roughly the same size.
Anisocytosis is usually caused by another medical condition called anemia. It may
also be caused other blood diseases or by certain drugs used to treat cancer. For this
reason, the presence of anisocytosis is often helpful in diagnosing blood disorders like
anemia. Treatment for anisocytosis depends on the cause. The condition isn’t
dangerous on its own, but it does indicate an underlying problem with the RBCs.
Symptoms of Anisocytosis: Depending on what is causing anisocytosis, the
RBCs might be:
larger than normal (macrocytosis), smaller than normal (microcytosis), or both (some
larger and some smaller than normal).
The main symptoms of anisocytosis are those of anemia and other blood disorders:
 weakness
 fatigue
 pale skin
 shortness of breath
Many of the symptoms are a result of a decrease in oxygen delivery to the body’s
tissues and organs.
Anisocytosis in turn is considered a symptom of many blood disorders.
Causes of anisocytosis:
Anisocytosis is most commonly a result of another condition called anemia. In
anemia, the RBCs are unable to carry enough oxygen to the body’s tissues. There
might be too few RBCs, the cells might be irregular in shape, or they may not have
enough of an important compound known as hemoglobin.
There are several different types of anemia that can lead to unequally sized RBCs,
including:

Iron deficiency anemia: This is the most common form of anemia. It occurs
when the body doesn’t have enough iron, either due to blood loss or a dietary
deficiency. It usually results in microcytic anisocytosis.

Sickle cell anemia: This genetic disease results in RBCs with an abnormal
crescent shape.

Thalassemia: This is an inherited blood disorder in which the body makes
abnormal hemoglobin. It usually results in microcytic anisocytosis.

Autoimmune hemolytic anemias: This group of disorders occur when the
immune system mistakenly destroys RBCs.

Megaloblastic anemia: When there are fewer than normal RBCs and the
RBCs are larger than normal (macrocytic anisocytosis), this anemia results. It’s
typically caused by a deficiency in folate or vitamin B-12.

Pernicious anemia: This is a type of macrocytic anemia caused by the body
not being able to absorb vitamin B-12. Pernicious anemia is an autoimmune
disorder.
Other disorders that can cause anisocytosis include:

myelodysplastic syndrome

chronic liver disease

disorders of the thyroid
In addition, certain drugs used to treat cancer, known as cytotoxic chemotherapy
drugs, can result in anisocytosis.
Anisocytosis may also be seen in those with cardiovascular disease and some cancers.
Complications of Anisocytosis
If left untreated, anisocytosis — or its underlying cause — can lead to:

low levels of white blood cells and platelets

nervous system damage

rapid heart rate

pregnancy complications, including serious birth defects in the spinal cord and
brain of a developing fetus (neural tube defects).
Poikilocytosis:
Poikilocytosis is the medical term for having abnormally shaped red blood cells
(RBCs) in blood. Abnormally shaped blood cells are called poikilocytes.
Normally, a person’s RBCs (also called erythrocytes) are disk-shaped with a flattened
center on both sides. Poikilocytes may:

be flatter than normal

be elongated, crescent-shaped, or teardrop-shaped

have pointy projections

have other abnormal features
RBCs carry oxygen and nutrients to your body’s tissues and organs. If RBCs are
irregularly shaped, they may not be able to carry enough oxygen.
Poikilocytosis is usually caused by another medical condition, such as anemia, liver
disease, alcoholism, or an inherited blood disorder. For this reason, the presence of
poikilocytes and the shape of the abnormal cells are helpful in diagnosing other
medical conditions.
Symptoms of poikilocytosis
The main symptom of poikilocytosis is having a significant amount (greater than
10 percent) of abnormally-shaped RBCs.
In general, the symptoms of poikilocytosis depend on the underlying condition.
Poikilocytosis can also be considered a symptom of many other disorders.
Common symptoms of other blood-related disorders, such as anemia, include:

fatigue

pale skin

weakness

shortness of breath
These particular symptoms are a result of not enough oxygen being delivered to the
body’s tissues and organs.
Causes of poikilocytosis?
Poikilocytosis is typically the result of another condition. Poikilocytosis conditions
can be inherited or acquired. Inherited conditions are caused by a genetic mutation.
Acquired conditions develop later in life.
Inherited causes of poikilocytosis include:

sickle cell anemia, a genetic disease characterized by RBCs with an
abnormal crescent shape

thalassemia, a genetic blood disorder in which the body makes abnormal
hemoglobin

pyruvate kinase deficiency

McLeod syndrome, a rare genetic disorder that affects the nerves, heart,
blood, and brain. Symptoms usually come on slowly and begin in midadulthood

hereditary elliptocytosis

hereditary spherocytosis
Acquired causes of poikilocytosis include:

iron-deficiency anemia, the most common form of anemia that occurs when
the body doesn’t have enough iron

megaloblastic anemia, an anemia typically caused by a deficiency in folate
or vitamin B-12

autoimmune hemolytic anemias, a group of disorders that occur when the
immune system mistakenly destroys RBCs

liver and kidney disease

alcoholism or alcohol-related liver disease

lead poisoning

chemotherapy treatment

severe infections

cancer

myelofibrosis
RED BLOOD CELL INCLUSIONS: