Poikilocytosis

As poikilocytosis ( ancient Greek ποικίλλω poikilo " colorful ", " different ", " diverse ", and ancient Greek κύτος CYTOS " cell") the occurrence of differently shaped, not round red blood cells in the cytological assessment erythrocytes ( a microscopic examination of the blood smear ) is called. These variously shaped, not round erythrocytes must make up at least 3%. The presence of poikilocytosis is non-specific, it can occur in all schwergradigen anemias.

• 2.1 Other forms of modification of the shape of the erythrocyte 2.1.1 anisocytosis

Etiology

Most often there is a Poikilocytosis by impaired erythropoiesis. Furthermore, can lead to suppression of erythropoiesis malignancies. Also faults and defects of the Erythrozytenmenbran can lead to poikilocytosis.

Certain diseases and injuries

The poikilocytosis is caused among other things by:

Iron deficiency anemia

See iron deficiency anemia

Pernicious anemia

See Pernicious anemia

Hereditary poikilocytosis

This rare disease called pyropoikilocytosis, goes to the member with severe hemolytic anemia and the resulting regular transfusion requirement associated. There, pronounced fragmentation of erythrocytes, as well as microcytic forms ( to Mikrozyt see below in the text) of the erythrocytes are possible. This Poikilocytes are heat-sensitive and osmotically unstable. In the severe forms of hereditary poikilocytosis a lack of spectrin may occur, so that elliptocytes and spherocytes may occur. In patients with this condition often exists homozygosity for a defect of the 2- alpha - spectrin.

Bone marrow damage

Damage to the bone marrow, it can by drugs (eg Azidamfenicol, cyclophosphamide ), chemicals, ionizing radiation come like leukemia and other cancers by infectious diseases (eg AIDS) and malignancies.

Forms of erythrocytes

The shapes of erythrocytes in the poikilocytosis can provide a diagnostic indication for the cause of poikilocytosis.

Selection:

• Anulozyt: hemoglobin- poor red cells with narrow rim, occurrence in iron deficiency and thalassemia
• Burr cell: A microcytic erythrocytes with one or more sharp outgrowths. Occurrence: Various forms of anemia, particularly uremia.
• Dakryozyt tears or cell: These teardrop-shaped erythrocytes, have a Ausziehung at a cell pole. Occurrence: Especially when myelofibrosis, rare in iron deficiency, myelodysplasia and other myeloproliferative syndromes.
• Drepanozyt or sickle cell: The red blood cells may be crescent, crescent - or dovetailed. This form of HbS indicates a content of about 50 % (see sickle cell anemia)
• Elliptozyt the red cells have an elliptical shape. Occurrence: Very rare inborn in hereditary poikilocytosis (see above), in excess of 50 % of all erythrocytes in ellipse form as well as in hyperlipidemia.
• Fragmentozyt or Schistozyt: convex side shows a well-circumscribed, semi-circular, intact membrane. On the concave side, however, shows an irregular boundary which arises because the erythrocyte this page a part of its volume has been demolished. Occurrence: Mechanical damage of erythrocytes intravascularly eg artificial heart valves. Thermal damage in severe burns.
• Howell - Jolly bodies
• Target cell: within the central region of the erythrocyte whitening there is a circular compression hemoglobin, so that the erythrocytes have a target -like appearance. Occurrence: thalassemia, sickle cell anemia, jaundice posthepatic, asplenia
• Sphärozyt: spherical shape of the normal-sized red blood cells.
• Stomatozyt: slot - or mouth -shaped central pallor

Other forms of modification of the shape of the erythrocyte

Anisocytosis

These are strong variations in size of the erythrocytes. There are erythrocytes, which are micro-and / or macrocytes and which accounts for more than 3% of all erythrocytes. The anisocytosis is the most common erythrocyte abnormality.

• Makrozyt: erythrocyte having a diameter greater than 10 microns.
• Mikrozyt: abnormal small with a diameter of less than 6 micrometer ( that is, the Mikrozyt is smaller than the core of the lymphocytes).