peripheral blood smear
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Introduction
Microscopic examination of blood obtained from a peripheral vein or capillaries.
Indications
- examination of cell morphology
- identification of parasites
Clinical significance
erythrocyte findings
- microcytosis & anisocytosis -> iron deficiency
- spherocytes -> warm autoimmune hemolytic anemia, hereditary spherocytosis
- macrocytes -> megaloblastic anemia, myelodysplasia, use of antimetabolite (nucleoside reverse transcriptase inhibitor)
- schistocytes -> microangiopathy
- schistocytes & thrombocytopenia -> TTP
- schistocytes & prosthetic heart valve -> heart valve leak
- RBC agglutination -> cold agglutinin hemolysis (Mycoplasma)
- rouleaux -> paraproteinemia (multiple myeloma)
- target cells -> thalassemia, hemoglobinopathy, liver disease
- sickle cells -> sickle cell anemia
- nucleated RBC -> marrow stress
- tear drop cells -> myelofibrosis, bone marrow granuloma, bone marrow infiltration
- bite cells -> G6PD deficiency
- burr cells -> kidney disease
- spur cells -> severe liver disease
- elliptocytes -> hereditary elliptocytosis
- stomatocytes -> hereditary stomatocytosis, artifact
Procedure
- Wright stain is commonly used for peripheral smears
More general terms
Component of
References
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 574-86
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 16, American College of Physicians, Philadelphia 2012
- ↑ Blevins SM, Greenfield RA, Bronze MS Blood smear analysis in babesiosis, ehrlichiosis, relapsing fever, malaria, and Chagas disease. Cleve Clin J Med. 2008 Jul;75(7):521-30 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18646588