1. Erythrocyte Abnormalities
Clinical Pathology,
Ms. Canga

2. Erythrocyte Morphology
Different species have different _________ RBCs with varying degrees of ___________________________.
Dogs have _____________ RBCs (~________ µm in diameter)
Cats, horses, cows, sheep, goats (3-4 µm)
Llamas and camels have ______________________ (oval) RBCs
Deer have _________________-shaped RBCs
Birds, fish, amphibians, and reptiles have ______________________, elliptical RBCs.
Human RBCs are about the same size as those of ______________.

3. Relative sizes of RBCs

4. Chicken Llama

5. Reptile Deer

6. Normal RBC Morphology
Feline blood. Normal erythrocyte morphology. Feline RBCs are smaller than dog erythrocytes, exhibit a slight amount of crenation, and have a minimal area of central pallor

7. Review
There are 5 ways to classify erythrocytes as normal or abnormal:
1) ________________________________________________
2) ________________________________________________
3) ________________________________________________
4) ________________________________________________
5) ________________________________________________

8. Arrangement on a Blood Film
How should cells appear on film?
Abnormal formation
_____________________ formation
_________________________________________

9. Rouleaux Formation Rouleaux formation
Grouping of RBCs that appear ________________
Normal in _________________
Seen with increased _______________ or ___________________ concentration in blood
May appear as an _________________
Refrigerated blood not allowed to return to room temperature
May be seen if blood has been held too long before preparation of smear

10. Rouleaux as an Artifact
As you learned in Lab Pro, rouleaux formation may be an artifact.
If it IS an artifact and not a true medical condition in the patient, ____________ may be added to the sample.

11. Rouleaux Formation
Electron microscope image.

12. Agglutination/Auto-agglutination
Agglutination is caused by an __________________ that coats the RBC causing bridging or clumping of the cells.
Typically occurs in _________________________ disorders
Agglutination MAY appear as __________________ on occasion
To differentiate between agglutination and rouleaux, saline is added to the sample.
On the next slide, are the EXACT procedures for adding saline to your sample:

13. Adding Saline to Confirm Rouleaux
When rouleaux is suspected, ____________________ all tubes in question.
Carefully remove ___________ /____________with transfer pipette, leaving the cells undisturbed. Discard/use plasma or serum
Add 2 drops of ________________ to test tube and mix well.
________________________the tube
Gently re-mix the red cells and perform smear
_________________ will disperse, ______________________________will NOT

14. Comparison in the Monolayer

15. Agglutination can Affect WBCs too!
Red blood cells (arrowhead)
And LYMPHOCYTES (arrow)

16. Variation in Color Called _______________________
____________________________
Calculated through the ___________ (Remember the formula?)
Classifies cells as ____________________ or _______________________

17. Polychromasia
Variation in color usually associated with __________ and ____________________
________ production begins right before cell loses nucleus
____________ intensity decreases as metabolic activity ____________________
________ increases in intensity as ________ production ______________________.

18. Polychromasia
Recall that the _______________ the cell in the RBC maturation series, the more dark blue the staining due to increased __________________ activity.
Mature RBCs stain _________ because they have their full complement of ________.
______ production begins right before cell loses ______________; immature RBCs with some Hb present stain ______________________ because there is still some metabolic activity going on within the cell.

19. Hypochromasia ____________ staining intensity of RBCs
Caused by insufficient ________ concentration due to _________ deficiency (Chronic ____________ loss or ______________________)
Cell will appear normally stained around __________________ with a much paler central region.
Hypochromasia is almost always accompanied by _____________________ . (Decreased __________)
Determined by a decreased ______________

20. Hypochromasia
Notice any Other problems?

21. Hyperchromasia Increased staining intensity of RBCs
Immature RBCs = larger and darker
Hyperchromasia based on _______ concentration (_______) cannot exist…
Presence of _______________, ___________________, and _____________can interfere with tests and _______________________ increase MCHC
_____________________ often seen
are __________________and __________________but can have normal cell volume. (Cell may be ________________)
May be seen in mismatched _________________________

22. Hyperchromasia/Spherocytes
What are they called? Detected primarily in which species?

23. Canine blood. Regenerative anemia with spherocytes
Canine blood. Regenerative anemia with spherocytes. Anisocytosis is due to macrocytic cells and spherocytes, which are smaller than normal and lack central pallor. Spherocytes are associated with hemolytic anemias due to immune disease or fragmentation. The polychromatophilic RBC with a rod- shaped area of central pallor (arrow) is a stomatocyte

24. Poikilocytosis Variations in the __________________ of RBCs
(poikil ~ irregular)
Not a __________________________
A general term to encompass nondescript variations in ______________ of erythrocytes that are scattered throughout the blood film.

25. Poikilocytosis
Note: Poikilocytosis, anisocytosis, and polychromasia are present on this slide.

26. Schistocytes “Helmet Cell”
RBC fragments resulting from shearing of red blood cell by _________________________________.
May be seen with _______________________________________ (DIC) or with ________________________
Expect to also see ________________________________ on blood film of animals with DIC
Can be caused by excess _______________deposition, malformation of _______________________, or excessive _________________________in the blood
Common name is “__________________________”

27. Schistocytes

28. Acanthocytes “Spur Cells”
Have irregular membrane projections of _______________________ length and diameter with __________________________tips
_______________________sized and spaced
May be seen in blood smear of:
Cats with _____________________________________,
Dogs with ___________________disease or
____________________________of the liver
Represent __________________ alteration rather than ________________________
Commonly called “________________”
In vivo = within patient
In vitro = outside of patient (Literally means “in glass”)

29. Acanthocytes

30. Echinocytes “Burr Cells”
__________________ change
Resulting from _____________ change in blood, altering cell _____________________
May appear __________________ or ruffled, with relatively _____________ sized and spaced, short, _________ projections
Associated with ____________ disease, ____________________ or rattlesnake _________________________in dogs
Can be _____________________ if excess of _______ is present

31. Echinocyte formation

32. Echinocytes

33. Echinocytes as“Crenation”
__________________ Change
______________________
Slow ________________ of blood film
_____________________EDTA tube
Affects the ________________ of the cells on a blood film

34. Crenation

35. Drepanocytes “Sickle Cells”
________________________ with pointed ends
Result of alteration in __________ due to low ___________ tension
Normal finding in ___________, Angora _________, and some ___________

36. Drepanocytes

37. Keratocytes “Helmet cell”
Also called “________________”
Keratocytes are believed to result from ____________________________________
Can also result from _________________ injury found with ___________ deficiency
Presence of keratocytes has also been associated with ____________________, _________________, ________________________, and various _________________ diseases.
Precurser called prekeratocytes or “Blister cells”

38. Keratocytes and Pre-keratocytes

39. Anulocytes “Punched-out cells”
____________ shaped RBCs that form as a result of a loss of the membrane ____________________.
Cell cannot return to normal shape after passing through a narrow _____________________.
May be seen in any _______________ disease.
Can also occur due to low _______ concentration or as an ____________________.

40. Anulocytes (Punched-out cells)

41. Dacryocyte “Teardrop cells”
_________________ shaped RBCs with a single ____________________ or _______________end
May be seen in _________________________ diseases or ____________ and ________________ disorders of dogs.
Can be an ______________ . Check to see if the _______________ are all pointing in the __________ direction.

42. Dacryocytes “Tear-drop Cells”

43. Eccentrocyte
Characterized by a shifting of the _______________ to one side of the RBC
____________ portion of membrane is ragged and poorly _______________________________.
Form under conditions of ___________________ stress
May be seen with ____________________________Anemia

44. Eccentrocyte
Also present in pic are Schistocyte and stomatocyte

45. Codocytes (Leptocytes)
Characterized by an increase in membrane _________________ _________
Include all of the following cells:
__________________________

46. Target Cells (Bull’s eye Cell)
Resembles a ____________ with a bulls-eye
Have central area of _____________ surrounded by area of pallor
_________________ of cell contains band of _______
A few may be seen in _____________ smears
May be associated with __________ deficiency, _________, ___________ diseases, and some _______________ disorders.

47. Target Cells

48. Folded cells and Stomatocytes
Folded cells have a ______________ _____appearing central pallor
_____________________ have a transverse, raised fold extending across the center of the cell and a clear, _________- like pale region in the center.
Both may be caused by a change in membrane _____________ associate with ______________ disease
Both are considered an ___________________ if the areas of pallor are ________________________ to the feathered edge.

49. Stomatocyte

50. Stomatocytes

51. Folded Cells

52. Knizocytes (Barr Cells)
Appear to have a bar of _________ through the central pallor.
Commonly observed in chronic ______________ disease
May be observed in any acute ______________ dysfunction
Caused by an alteration in the ______________ content of cell membrane

53. Knizocytes or “Barr Cells”

54. Some Poikilocytes at a glance

55. Test yourself!  Schistocytes Spherocytes
Basophilic stippling and Stomatocytes
Howell-Jolly bodies

56. Presence of Structures on/in Erythrocyte
Many different abnormalities caused by variety of different conditions.
__________________________

57. Howell-Jolly bodies
__________________________ nuclear remnants observed in young RBCs during their response to __________________________ anemia
Normally, as cells containing nuclear remnants pass through the _______________ , _________________ cells remove the remnants.
Therefore, HJBs may be seen with ________________ disease or in an animal with the _____________removed.

58. Howell-Jolly bodies

59. Basophilic Stippling
Observed in RBCs that contain abnormal, residual ___________.
Small, dark blue “__________________” within the RBC.
Occasionally seen in __________________ RBCs in _____________ cats.
Characteristic finding with __________________________ in dogs.

60. Basophilic Stippling

61. Heinz Bodies
Particles of __________________________, resulting from oxidative injury, attach to RBC _______________________.
They stain blue with _________________________________ and appear as a _________________ area with Diff-quick stain.
Seen in _________________________ and ______________ ingestion in cats and dogs
HBs are often increased in concentration with diseases such as _____________________ , ______________________, and ______________________________ in cats
Normal cat blood may have up to _____%

62. Heinz bodies Left = stained with New Methylene Blue
Right = stained with DiffQuick stain

63. Reticulocytes
Immature RBC; contains _________________ (ribosomes) and residual RNA that are lost as the cell matures.
A.k.a. ‘____________________________ RBC’ (when stained with _______________________ and not NMB)
NMB causes visualization of clumping of residual organelles, referred to as ‘______________________’.
Cats have two forms: ___________________ and _____________________.

64. Reticulocytes

65. Canine Distemper Viral Inclusions
Seen in RBCs of dogs with _________________.
__________________________
Variable in _________, __________, ________ and _________(faint blue to magenta).
More frequently seen in ________________________ RBCs than _______________RBCs.
Can also be seen in ___________________ and _____________________.

66. Viral Distemper inclusions

67. Blood Parasites that Affect RBCs
Parasites may be present ____________ or _____ the surface of RBCs
Stain ___________________ and drying ________________ are sometimes confused with RBC parasites.

68. Babesia spp.
_____________________ or __________shaped, ______________________, paired inclusions
Transmitted via ______________
Causes ___________________ anemia
Commonly identified at __________________ edge of blood smears
Seen in __________, __________, __________, __________, and ______________

69. Babesia spp. Babesia bigemina = top 3 rows
Babesia canis = bottom 3 rows

70. Mycoplasma haemofelis
Formerly known as: ____________________________
Disease = Feline Infectious __________________ Anemia
May be, coccoid, rod-shaped, or ringlike structures, but usually appear as short, dark purple ________on the __________________ of RBCs
Organisms usually detach from the RBC when placed in _________________________.
Cyclic ____________________, organisms may be numerous, scarce or not found in a given blood sample – examine blood at different _____________of the day
May be transmitted by ______________

71. Mycoplasma haemofelis

72. Mycoplasma haemocanis
Formerly known as ___________________________
Rare; Usually only occurs in ________________________ or immunosuppressed dogs.
Organism appears as a chain or small cocci or rods that stretch across _____________ of RBC.
Chains may appear “_____________________.”

73. Mycoplasma haemocanis

74. Cytauxzoon felis Causes a ______________ disease in cats
Small, ring or _______________-shaped bodies in red cells
Causes a ______________ disease in cats
Transmission is by ____________
Rare cause of _________________ anemia
No known _________________

75. Cytauxzoon felis