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.
The peripheral blood picture showed macrocytes, macro ovalocytes
, hyper segmented neutrophils, and bone marrow showed erythroid hyperplasia, megaloblastic type (Fig 1).