University of Virginia Health System

Echinocyte
(Burr cell, crenated red cell)

Peripheral smear, Wright-Giemsa stain, 1000x

 Definition:

Red cell membrane abnormality characterized by short, blunt projections (spicules) of relatively uniform length and evenly distributed over the red cell surface. In early stage of development the red cell maintains a discoid shape (echinocyte I), but may progress to a spherical shape (echinocyte IV, spheroechinocyte).

Pathobiology:

Due to an expansion of the outer leaflet of the lipid bilayer, and the abnormality is reversible.

• Artifact- blood smear improperly prepared, usually due to a delay in the preparation of the blood smear from EDTA-anticoagulated blood sample.
• Aging of red cells in vitro, e.g. transfused blood- due to ATP depletion and lysolecithin formation.
• Renal insufficiency
• Impact hemolysis
• Liver disease
• Hypophosphatemia and hypomagnesemia (malnutrition)
• Pyruvate kinase deficiency
• Severe burns

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