Poikilocytosis: What is it, types and when it occurs

Poikilocytosis is a term that can appear in the blood count and means the increase in the number of poikilocytes circulating in the blood, which are hematíes that have an abnormal shape. The erythrocytes have a rounded shape, are flat and have a clearer central region due to the distribution of hemoglobin. Thanks to alterations in the membrane of erythrocytes, alterations can occur in its form, resulting in hematíes with a different form in the blood circulation, which can interfere with its function.

The main poikilocytes identified in the microscopic evaluation of the blood are the drepanocitos, the dacriocitos, the eliptocitos and the codocitos, the cuales appearing in the anemias; For this reason, its identification is important so that the differentiation between the anemias can be established, allowing the diagnosis and the beginning of the most appropriate treatment.

types of poikilocytes

The poikilocitos can be observed through the microscope from the realization of a blood frotis, being them:

• Spherocytes: erythrocytes with a round shape and smaller size than normal erythrocytes;
• Dacrocytes: teardrop or droplet-shaped erythrocytes;
• Acanthocytes: erythrocytes that have a spiny appearance, being able to be similar to the shape of a corcholata (plate) of a glass bottle;
• Codocytes: erythrocytes in the form of “shot target” (diana) due to the distribution of hemoglobin;
• Elliptocytes: oval-shaped erythrocytes;
• Drepanocytes: hoz-shaped erythrocytes, which appear mainly in sickle cell anemia;
• Stomatocytes: erythrocytes that have a narrow area in the center, similar to a mouth;
• Schizocytes: indefinitely shaped erythrocytes (amorphous).

In the hemogram report, in case poikilocytosis is determined during the microscopic examination, the presence of the identified poikilocytosis is indicated. Identification of poikilocitos is important so that the doctor can know the general condition of the person and, according to the observed alteration, can indicate the performance of other exams to complete the diagnosis and start the immediate treatment.

When poikilocitos can appear

Poikilocytes appear as a consequence of alterations related to erythrocytes, such as biochemical alterations in the membrane of these cells, metabolic alterations of enzymes, abnormalities related to hemoglobin and aging of the blood. These changes can occur in different diseases, resulting in poikilocytosis, siendo the main situations:

1. Sickle cell anemia

Sickle cell anemia is a disease characterized mainly by the alteration in the form of the hematíes, los cuales poseen a form similar to a hoz (sleep cell). This is due to the mutation of one of the chains that form the hemoglobin, which reduces the ability to unite the hemoglobin with oxygen and, consequently, the transport to the organs and the tissues, and increases the difficulty for the globules rojos pasen through las venas.

As a result of this alteration and reduction of the oxygen transport, the person feels tired in excess, presents generalized pain, pallor and delay in growth, for example.

In certain cases, despite the fact that the sickle cell is characteristic of sickle cell anemia, it is also possible to observe the presence of codocytes.

2. Myelofibrosis

Myelofibrosis is a type of myeloproliferative neoplasm that is characterized by the presence of circulating dacrocytes in peripheral blood. Normally, the presence of these dacrocytes is indicative that there are alterations in the bone marrow, which is what occurs in myelofibrosis.

This type of neoplasm is characterized by the presence of mutations that promote changes in the process of cell production in the bone marrow, with an increase in the number of mature cells in this site, which favors the formation of scarring in the bone marrow, decreasing its function at a long time.

3. Hemolytic anemias

Hemolytic anemias are characterized by the production of antibodies that react against erythrocytes, promoting their destruction and causing the emergence of symptoms of anemia, such as tiredness, pallor, tenderness and weakness, for example. As a consequence of the destruction of erythrocytes, there is an increase in the production of blood cells by the bone marrow and by the bazo, being able to generate the production of abnormal red blood cells, such as esferocitos and elliptocitos. Find out more about hemolytic anemia.

4. Liver diseases

The diseases that affect the liver can also cause the emergence of poikilocytes, mainly stomatocytes and acanthocytes, being necessary to carry out other exams to evaluate the hepatic activity and, if possible, establish the diagnosis of some alteration.

5. Hierro deficiency anemia

Iron deficiency anemia, also called iron deficiency anemia, is characterized by the decrease in the amount of circulating hemoglobin in the body and, consequently, of oxygen; This is because the hierro is important for the formation of hemoglobin. In this way, signs and symptoms such as weakness, tiredness, discouragement and fainting appear. The reduction of the amount of circulating hierro can also favor the emergence of poikilocytes, mainly codocytes. Learn more about iron deficiency anemia.