Poikilocytosis

Poikilocytosis refers to the presence in the blood of poikilocytes. Poikilocytes are abnormally shaped red blood cells^[1] as seen on a blood film in humans and many wild and domestic species of animals, though they are common in some clinically normal small ruminants, particularly goats.

Normal red blood cells are round, flattened disks that are thinner in the middle than at the edges, whereas a poikilocyte is either a distortion of that normal shape or an entirely different shape. Generally, poikilocytosis can refer to an increase in abnormal red blood cells of any shape where they make up 10% or more of the total population.

Causes of poikilocytosis

Rather than being seen as a sign of any one disease, poikilocytosis is a rather general condition. There may, however, be a predominance of one particular type of abnormally shaped red cells, some of which may indicate possible presence of a specific disease or disorder.^[2]

Abnormal red blood cells are seen in a wide range of conditions, so poikilocytosis is not specific. However, specific types of poikilocytes may be seen in particular disease states and/or disorders.

Types

Membrane Abnormalities

1. Acanthocytes or Spur/Spike cells
2. Codocytes or Target cells
3. Echinocytes and Burr cells
4. Elliptocytes and Ovalocytes
5. Spherocytes
6. Stomatocytes or Mouth cells

Trauma

1. Dacrocytes or Teardrop Cells
2. Keratocytes
3. Microspherocytes and Pyropoikilocytes
4. Schistocytes
5. Semilunar bodies

Treatment

In all cases, the treatment of poikilocytosis depends on its cause. For example, poikilocytosis can be caused by a vitamin deficiency, in which case the treatment is to take Vitamin B12 or folic acid. It can be caused by a digestive disease, such as celiac disease, in which case the solution may lie in treating the underlying celiac disease so that nutrients can be properly absorbed.

References