Saturday, March 8, 2014

Crenated RBCs (Echinocytes)

Crenated RBCs (Echinocytes)




Background Information of Crenated RBCs (Echinocytes)

Echinocytes or the most commonly known crenated RBCs are a shape abnormality seen in blood. Its non-specific clinical significance is often lead to their presence being neglected.  They are characteristically seen with spiny projections dispersed regularly around the cell surface and contains adequate hemoglobin
Clinical Significance
When crenated RBCs are seen in the good-for-examination area of a well-made smear using fresh blood, these cells are actual RBC shape abnormality. These cells are characteristically found in post splenectomy patients with enzayme abnormalities of the erythrocyte glycolysis system.
  • Pyruvate Kinase deficiency: The RBC glycolysis system is disrupted leading to lack of ATP which then impairs the NA+/K+ ATPase and ATP-dependent processes, resulting in the cellular loss of K+ and water and increased intracellular NA+ accumulation.
  • Drugs (Salicytes, phenylbutazone, fluorsemide) and chemotherapeutic agents (Aoxorubicin): these causes the expansion of the leaflet of the RBC membrane.
Non-Clinical Significiance

Crenated RBCs are often found in smear that have been dried for too long and "aging" of the blood in EDTA tube. Furthermore older RBCs that are nearing their half-life are more prone to this transformation into crenated configuration. More commonly, crenated RBCs are found in underfilled EDTA collection tubes (diagram below) and corrective actions such as making a new smear or re-collecting the sample must be performed.

Hence, when seen on PBFs, these crenated RBCs are actually artefactual and have no clinical value.True burr cells are less numerous.
 


Cellular Description
The hallmark of crenated RBCs/Echinocytes is the presence of RBCs that have numerous evenly spaced projections surrounding the membrane. They are stained normally as they still contain adequate hemoglobin. 
However Echinocytes are often not reported as they are often seen as artefacts in many cases and is a non-specific abnormality, hence it is difficult to distinguish the "real" echinocytes from artifacts.
 

16 comments:

  1. Why they become like this? I mean why causes the star shape instead of just roling

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    Replies
    1. I think it is explained the pyruvate kinase deficiency

      Delete
  2. Chemicals used in industries gives me Leukemia and it's all started when I wanted to get off my job to get another job that when I got diagnose, at that very point I was so scared to die because it has infected my blood cells also I was prescribed drugs like Cyclophosphamide,Busulfan,Bosutinib,Cytarabine, Cytosar-U (Cytarabine),Dasatinib in all that was just to keep me waiting for my dying day. I got inspired by what I read from a lady on blog spot on how Dr God hands cure her HIV/Aids with herbal medicine then they were lettered below that says he can cure Cancer so I pick his contact on the testimony she wrote then I emailed Dr God hands hopefully he replied swiftly to my mail then I purchased his Herbal medicine also it was shipped to me here in Texas, I went to pick it at post office so he instructs me on how the treatment will take me three weeks to cure my Leukemia Disease, Joyfully I was cured by this Dr God hands Herbal Medicine.
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