Spherocytes and reticulocytes from Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions, presented by MediaLab

Erythrocyte Disorders: Smear Case 1: Jaundice and the Peripheral Smear

Spherocytes and reticulocytes

The photograph represents peripheral blood smear findings in another patient with hereditary spherocytosis.
The red cells vary in size (anisocytosis)with a mixture of microcytes (red cells with central pallor) and microspherocytes (red cells with central staining).
Macrocytes are conspicuous, some staining light blue. They are immature erythrocytes (reticulocytes)released from the bone marrow early. The bone marrow, geared up for rapid cell release in response to severe hemolysis, expels young red blood cells into the circulation before completing their 24 hour maturation cycle.
Hemolysis, jaundice, and gall stone formation disappear following splenectomy. Gallbladder and stone removal eliminate the right upper quadrant pain.
A serious consideration, especially in children with hereditary spherocytosis, is hemolytic crisis.
A viral infection may allow red blood cell destruction to continue unabated. Anemia of such sudden onset and severity may become catastrophic, with death as the outcome. Splenectomy removes this possibility.

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