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Fragmented red cells or schistocytes (Figure 3--Slide E) often results from mechanical break-up/resealing of red cells in the periphery by microthrombi [35].
Red cell shapes Differential diagnosis Irreversibly sickled red Sickle cell syndromes(SS, SC, cells (drepanocytes) Spthalassemia) Target cells (codocytes, Sickle cell disease, haemoglobin mexican hat cells) C trait, haemoglobin CC disease, thalassemias, iron deficiency, Liver disease (cholestasis), asplenia, Fragmented red cells Thrombotic micro-angiopathic (schistocytes, helmet haemolytic anaemias such as cells, keratocytes) Disseminated intravascular coagulopathy (DIC), thrombotic thrombocytopenic purpura, haemolytic uraemic syndrome.
The blood film showed schistocytes and fragmented red cells and a diagnosis of TTP was first considered.
Her blood film showed fragmented red cells, which suggested the diagnosis of microangiopathic haemolytic anaemia.