Peripheral blood smear
Author:
Mikael Häggström [note 1]
Look at and comment separately on white blood cells, red blood cells and platelets.
Red blood cells
Automatic quantification of mean corpuscular volume (MCV) and red blood cell distribution width (RDW) generally decides whether you will call the sample "normocytic" versus "microcytic"/"macrocytic" and/or "anisocytotic", even if it is not clearly visible in the microscope.
High RDW
| RDW in adults[1] | Terminology[1] |
|---|---|
| 14.5% - 18% | Mild anisocytosis |
| 18% - 26% | Moderate anisocytosis |
| > 26% | Severe anisocytosis |
High RDW may be a result of the presence of fragments, groups of agglutination, and/or abnormal shape of red blood cells.[2]
- Iron-deficiency anemia usually presents with high RDW and low MCV.
- Folate and vitamin B12 deficiency anemia usually presents with high RDW and high MCV.
- Mixed-deficiency (iron + B12 or folate) anemia usually presents with high RDW and variable MCV.
- Recent hemorrhages typically present with high RDW and normal MCV.
- A false high RDW reading can occur if EDTA anticoagulated blood is used instead of citrated blood. See Pseudothrombocytopenia.
Schistocytes (fragmented parts red blood cells) only needs mentioning if constituting over 1% of red blood cells.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
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References
- ↑ 1.0 1.1 . High RDW level in the blood. MrLabTest. Last update: 12/01/2021
- ↑ . Red Cell Distribution Width (RDW): Reference Range, Interpretation, Collection and Panels. Medscape Reference (2017-01-07).
Image sources