Background Information of Polychromasia
Basophilic stippling refers to erythrocytes (RBCs) on a PBF that display small purplish dots (stippling) throughout their cytoplasm. These small dots are an spontaneous abnormal agregation of nucleic acid (RNA and mitochondria). These stippling is only obvious in the cell after it has been stained with a basic (alkaline) dye (eg: Wright Stain) as the name "basophilic" suggest. The alkaline dye will interact with the negatively charged molecules inside a cell to produce the purplish coloration observed under microscope.
Fine stippling may be associated with polychromatophilia, while coarse stippling usually indicates impaired erythropoiesis (regenerative anemia). Additionally, presence of these RBCs with basophilic stippling characteristics indicates the presence of an on-going disease including:
- Sideroblastic anemia
- Lead poisoning (microcytic anemia)
- Arsenic poisoning
- Hereditary Pyrimidine 5'-Nucleotidase Deficiency
- Thrombotic thrombocytopenic purpura
The hall mark of basophilic stippling is the presence of RBCs with purplish "granules/dots" surrounding throughout their cytoplasm. These abnormal RBCs usually appear slightly bigger than the normal RBCs.