Non-spiculated variants include target cells, ovalocytes
12] deficiency could have been affecting his mental status; consequently, we ordered routine laboratory work-up that included a complete blood count with differential and peripheral smear, which showed macrocytic anemia and ovalocytes
WBC Toxic granulations 28 Dohle bodies 5 Vacuolations 38 Smudge cells 32 Clefted lymphocytes 10 Hairy projections 2 Auer rods 2 RBC Anisocytosis 54 Poikilocytosis 31 Microcytosis 7 Macrocytosis 2 Hypochromasia 3 Polychromasia 35 Echinocytes (burr cells) 19 Dacrocytes (teardrops) 16 Spherocytes 6 Target cells 2 Acanthocytes 1 Ovalocytes
28 Schistocytes 5 Stomatocytes 2 Howell-Jolly bodies 1 Basophilic stipplings 5 Platelet Clumped platelets 3 Platelet satellitosis 5 Large platelets 8 Giant platelets 8 Overall Cell Morphology Code Concordance, Overall Type % Concordance, % WBC Toxic granulations 78.
The red cell morphology showed anisocytosis, poikilocytosis with occasional teardrop cells, spherocytes, ovalocytes
, and a few schistocytes.
Peripheral smear showed numerous microcytes and ovalocytes
The peripheral blood picture showed macrocytes, macro ovalocytes
, hyper segmented neutrophils, and bone marrow showed erythroid hyperplasia, megaloblastic type (Fig 1).
On the peripheral blood smear, RBC morphology showed slight anisocytosis with few ovalocytes
and many schistocytes, WBC morphology was within normal ranges, and platelet morphology was normal.