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Pathologic Red Blood Cell (RBC) Morphologies and Associated Diseases

Acanthocyte (spur cell),  
Basophilic stippling, 
Bite cell,
Red Blood Cell (RBC ... cell, Other RBC ... Howell-Jolly bodies #RBC ... Microscopy #Pathology #Hematology ... #BloodSmear
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Red Blood Cell (RBC ... Morphology Microcytic RBC ... Sickle Cell RBC ... #Morphology #differential ... #diagnosis #hematology
Causes of Anemia with elevated Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Normal Blood Smear
 •
Volume (MCV) - Differential ... Diagnosis Algorithm ... Neutrophils - Low RBC ... Cells, Normal WBCs ... #Causes #Hematology
Overall Approach to Anemia - Differential Diagnosis Algorithm

Blood Loss
 • Acute Bleed - Normocytic / Normochromic
Decreased RBC ... Anemia of Chronic Disease ... Thalassemia • RBC ... Disorder • RBC ... #Causes #Hematology
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Diagnosis Framework ... 2) External (RBC ... Defects, Drugs, Liver ... 3) Internal (RBC ... #Diagnosis #hematology
Red Blood Cell (RBC) Morphology Atlas
 • Microcytic - Iron-deficiency anemia, Thalassemia, Sideroblastic anemia, Lead poisoning
Red Blood Cell (RBC ... , Liver diseases ... coagulopathy (DIC) #RBC ... #differential # ... hematology
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Autoimmune hepatitis, PBC ... stone, Malignancy, PBC ... • Bilirubin: RBC ... cardiac muscle, RBC ... • LDH: Heart, RBC
Bandemia Overview

Normal: < 1%
Clinically significant: > 10%

Band neutrophils are slightly less mature than segmented neutrophils and
Even with normal WBC ... relative to both WBC ... bacteremia • Abnormal WBC ... 21% had normal WBC ... #WBC #CBC #hematology
Causes of Thrombocytosis - Differential Diagnosis Algorithm
Spurious:
 • Artifact (redo CBC)
Autonomous:
 • Essential thrombocytosis
 • Polycythemia
Thrombocytosis - Differential ... Diagnosis Algorithm ... Artifact (redo CBC ... disorders • Celiac disease ... #Causes #Hematology
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Pathophysiology ... cholestasis → Cirrhosis/Liver ... or higher • Liver ... bile ducts Differential ... #workup #hepatology