- Types of poikilocytes
- When poikilocytes may appear
- 1. Sickle cell anemia
- 2. Myelofibrosis
- 3. Hemolytic anemias
- 4. Liver diseases
- 5. Iron deficiency anemia
Poikilocytosis is a term that can appear in the blood picture and means an increase in the number of poikilocytes circulating in the blood, which are red cells that have an abnormal shape. Red blood cells have a rounded shape, are flat and have a lighter central region in the center due to the distribution of hemoglobin. Due to changes in the membrane of red blood cells, there may be changes in their shape, resulting in the circulation of red blood cells with different shape, which can interfere with their function.
The main poikilocytes identified in the microscopic evaluation of blood are drepanocytes, dacryocytes, ellipocytes and codocytes, which frequently appear in anemias, therefore it is important to identify them so that anemia can be differentiated, allowing the diagnosis and the beginning of treatment more appropriate.
Types of poikilocytes
Poikilocytes can be observed microscopically from the blood smear, which are:
- Spherocytes, in which the red cells are round and smaller than the normal red cells; Dacryocytes, which are red blood cells with a teardrop or drop shape; Acanthocyte, in which the erythrocytes are spiculated in shape, and may be similar to the shape of a glass bottle cap; Codocytes, which are the red cells in target shape due to the distribution of hemoglobin; Elliptocytes, in which the erythrocytes have an oval shape; Drepanocytes, which are sickle-shaped red blood cells and appear mainly in sickle cell anemia; Stomatocytes, which are red blood cells that have a narrow area in the center, similar to a mouth; Schizocytes, in which the erythrocytes have an indefinite shape.
In the hemogram report, if poikilocytosis is found during the microscopic examination, the presence of the identified poikilocyte is indicated in the report. The identification of poikilocytes is important so that the doctor can check the general condition of the person and, according to the observed change, can indicate the performance of other tests to conclude the diagnosis and start the treatment afterwards.
When poikilocytes may appear
Poikilocytes appear as a consequence of changes related to red blood cells, such as biochemical changes in the membrane of these cells, metabolic changes in enzymes, abnormalities related to hemoglobin and aging of red blood cells. These changes can happen in several diseases, resulting in poikilocytosis, being the main situations:
1. Sickle cell anemia
Sickle cell anemia is a disease characterized mainly by the change in the shape of the red blood cell, which starts to have a shape similar to a sickle, becoming known as a sickle cell. This happens due to the mutation of one of the chains that form hemoglobin, which decreases the ability of hemoglobin to bind to oxygen and, consequently, the transport to organs and tissues, and increases the difficulty for the red blood cell to pass through the veins.
As a result of this alteration and decreased oxygen transport, the person feels excessively tired, has generalized pain, pallor and growth retardation, for example. Learn to recognize the signs and symptoms of sickle cell anemia.
Although sickle cell is characteristic of sickle cell anemia, it is possible to observe, in some cases, the presence of codocytes.
2. Myelofibrosis
Myelofibrosis is a type of myeloproliferative neoplasia that has the characteristic of the presence of dacryocytes circulating in the peripheral blood. The presence of dacryocytes is most often indicative that there are changes in the bone marrow, which is what happens in myelofibrosis.
Myelofibrosis is characterized by the presence of mutations that promote changes in the production process of cells in the bone marrow, with an increase in the amount of mature cells in the bone marrow that promote the formation of scars in the bone marrow, decreasing their function over time. Understand what myelofibrosis is and how treatment should be.
3. Hemolytic anemias
Hemolytic anemias are characterized by the production of antibodies that react against red blood cells, promoting their destruction and leading to the appearance of anemia symptoms, such as tiredness, pallor, dizziness and weakness, for example. As a consequence of the destruction of red blood cells, there is an increase in the production of blood cells by the bone marrow and spleen, which may result in the production of abnormal red blood cells, such as spherocytes and ellipocytes. Learn more about hemolytic anemias.
4. Liver diseases
Diseases that affect the liver can also lead to the emergence of poikilocytes, mainly stomatocytes and acanthocytes, requiring further tests to assess the activity of the liver if it is possible to diagnose any changes.
5. Iron deficiency anemia
Iron deficiency anemia, also called iron deficiency anemia, is characterized by a decrease in the amount of circulating hemoglobin in the body and, consequently, oxygen, because iron is important for the formation of hemoglobin. Thus, signs and symptoms appear, such as weakness, tiredness, discouragement and feeling faint, for example. The decrease in the amount of circulating iron can also favor the appearance of poikilocytes, mainly codocytes. See more about iron deficiency anemia.
