Haemolysis: Blood Film
The Peripheral Blood film
is essential for making a diagnosis of haemolysis. Different types of haemolysis are associated with different morphological features
Spherocytes
are spherical red cellswhich have lost some of their membrane,
without an accompanying loss in cytoplasm.
This is usually the result of
a congenital membrane defect,
or opsonisation and extravascular haemolysis.
Schistocytes (fragments).
These are seen in microangiopathic haemolytic anaemia (MAHA), which often results in thrombotic microangiopathy (TMA).
Blister cells
. These are seen in oxidative haemolysis.
Poikilocytes and target cells.
This is a blood film from a patient with thalassaemia major. There are poikilocytes (abnormally-shaped cells), target cells and teardrop cells,
which signifies marked dyserythropoiesis.
