Abstract:The hallmark of the microangiopathic hemolytic anemia is the presence of fragmented, distorted red blood cells (schistocytes) on the peripheral blood smear of a patient with hemolytic anemia (> Fig. 3...The hallmark of the microangiopathic hemolytic anemia is the presence of fragmented, distorted red blood cells (schistocytes) on the peripheral blood smear of a patient with hemolytic anemia (> Fig. 323.1). It does not represent a specific diagnostic entity, but rather a morphologic manifestation of mechanical destruction and fragmentation of the red blood cells by shear stress as they pass through fibrin strands deposited on the vascular endothelium or within small blood vessels. Its clinical value lies in narrowing the differential diagnosis in a patient with hemolytic anemia. It should be remembered that a small number of schistocytes may be present in normal individuals. Mild increase in the number of schistocytes may be seen in some diseases with no evidence of hemolysis, i.e., renal disease, prosthetic heart valve, and preeclampsia. The presence of more than 1% of schistocytes or two schistocytes per high power field on a well prepared blood smear is suggestive of microangiopathic hemolytic anemia. Several disease processes may be associated with microangiopathic hemolytic anemia (> Table 323.1). The clinical manifestations are those of the hemolytic anemia and the manifestations of the underlying precipitating condition. Following is a discussion of disease entities associated with microangiopathic hemolytic anemia.Read More
Publication Year: 2012
Publication Date: 2012-01-01
Language: en
Type: article
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