Wednesday, August 31, 2016

Study group discussion: Different sized spherocytes

The difference in size of spherocytes has significance. It is assessed manually, on peripheral smear examination.

What's the importance of assessing size difference of spherocytes?
Well, the main differentials of spherocytosis are:

1. Autoimmune hemolytic anemia (AIHA)
2. Hereditary spherocytosis (HS)

Looking at the size difference between spherocytes helps you differentiate between the two.

HS has microspherocytes. Minimal size variation. 
AIHA has spherocytes of variable sizes. Large and small.

Spherocytes can also be found in a post transfusion patient. So it's essential to take history before interpreting. 

Important to remember for future pathologists: Don't look for spherocytes at tail of peripheral smear. Only look at body and tail junction. Or in body of smear. Because they can be artefactually present at tail.

Thanks, Divya, an amazing pathologist, for explaining this to us :)

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