Background Information of Elliptocytes/Ovalocytes
Elliptocytes/Ovalocytes are abnormally shaped red blood cells that appear oval or elongated. In normal circumstances, RBCs may only assume this configuration to allow passing through capillaries. This may be found on almost any peripheral blood smear (~1%). However in abnormal circumstances (>25%), hereditary elliptocytosis (HE) is probable. In most cases, patients are asymptomatic while having normal red blood cell life spans, although a mild anemia may occur. Resistance to malarial infection may be a beneficial attribute of HE.
Elliptocytes/Ovalocytes formed because their cytoskeleton scaffold of the cell is destablised hence when RBCs get deformed when they squeeze through capillaries, it is unable to regain its original shape. This configuration will prompt the spleen to remove them swiftly and this may result in anemia as mentioned earlier. This may then lead to splenomegaly as the spleen may be over-worked to remove this abnormal-shaped RBCs.
These abnormal red blood cells are seen in blood films of patients with:
- Hereditary elliptocytosis
- Iron deficiency
- Myelophthisic anemia
- Megaloblastic anemia
Red cells varying in shape from elongated to oval, and rich in hemoglobin, hence almost 90% stained red.