13] In ABO HDFN, microspherocytes
were frequently prominent in blood films and red cell osmotic fragility was almost always above normal limits for upto 2-3 weeks after birth.
The RBC autoantibodies that result in a predominately extravascular hemolysis can cause spherocytosis, predominately composed of microspherocytes
with a diameter of 5 iM or less (Figure, A).
1: Blood smear with microspherocytes
and schisto- cytes (Giemsa stain).
Diagnoses were based on low-level hemoglobin, fragmented red cells, microspherocytes
, polychromasia, macrocytosis, nucleated red cells on peripheral blood smear, elevated reticulocytes, and positive direct Coombs test (IgG+C3).
In HS, the electrophoresis is normal, and the presence of microspherocytes
on the blood smear confirms the diagnosis.
64 mg/dl and her peripheral blood smear showed red cell fragments and microspherocytes
Examination of the peripheral blood film reveals a marked decrease in platelets, polychromic RBCs, and RBC fragmentation with microspherocytes
, schistocytes, and keratocytes characteristic of microangiopathic hemolytic anemias.
Table 1 Laboratory features of : hemolytic uremic syndrome Anemia -- often severe Moderate neutrophilia Fragmented RBCs, burr cells, and microspherocytes
Reticulocytosis Thrombocytopenia Hemoglobinemia Low haptoglobin Mildly elevated bilirubin Elevated urea nitrogen and creatinine Hemoglobinuria with RBCs, WBCs, and casts
Grumbach summarised that in ABO HDFN microspherocytes
were frequently prominent in blood films.
Peripheral smear showed large number of microspherocytes
, microcytic hypochromic cells, target cells and occasional red cells with basophilic stippling (Figure 1).
Examination of a well-prepared peripheral blood film from a patient with HS reveals many characteristic microspherocytes
, which appear as very deeply stained red cells with decreased diameters and without central pallor.
Examination of the peripheral blood smear revealed microspherocytes
, polychromasia, and a few nucleated red blood cells.