Red Blood Cell (RBC):- Part 5 – RBC Morphology Differential Diagnosis, and Interpretations

Sample

• Direct blood smear or blood in EDTA can be used.

Indications

1. To diagnose anemia.
2. For typing of the anemia.

RBC morphology and Interpretation:

RBC morphology	Lab findings	Causes
Microcytosis	RBC diameter <6 µm MCV < 80 fl MCHC < 27%	Iron deficiency anemia Anemia due to chronic diseases Thalassemia
Macrocytosis	RBC diameter > 8 µm	Megaloblastic anemia
Hypochromic	RBC has a central pallor area	Decreased Hb contents Iron deficiency anemia
Poikilocytosis	RBC has variable shapes	Sickle cell anemia Leukemias Microangiopathic hemolysis Extramedullary hematopoiesis
Anisocytosis	RBC has a variable size	Reticulocytosis Blood transfusion into microcytic or macrocytic anemia
Spherocytosis	RBC has no biconcavity RBC has no central pallor MCHC  is high	Hereditary spherocytosis Loss of cell membrane relative to cell volume
Acanthocytosis	RBC has spiculated surface	Liver diseases Abetalipoproteinemia
Elliptocytosis	RBCs are an oval	Hereditary defect This is usually harmless

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