University of Virginia Health System

Spherocyte

Peripheral blood smear, Wright-Giemsa stain, 1000x

Description:

Spherical-shaped and hyperchromic red cell with loss of central palor, an increase in MCHC, and a low normal MCV. Microspherocytes have a decreased MCV. A variable degree of polychromatophilia (reticulocytosis) is usually present.

Pathobiology:

Due to a loss of red cell membrane without an equal loss of hemoglobin as a result of several mechanisms.

Differential:

• Increased rate of red cell destruction
• Hereditary spherocytosis
• Autoimmune hemolytic anemia (idiopathic, secondary, drug-induced)
• Heinz body hemolytic anemia
• Hemolytic transfusion reactions
• Oxidative damage to red cell, e.g. G-6PD deficiency
• Toxins, e.g. Clostridium perfringens, snake venoms
• Sepsis
• Severe burns
• Water intoxication
• Rh null phenotype (stomatocytes also seen)

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