Laboratory findings may include abnormal urinalysis findings (proteinuria, hematuria, or casts), schistocytes
on blood smear, anemia, thrombocytopenia, increased BUN and creatinine, hyperkalemia, and coagulation study results within reference intervals.
Thrombotic thrombocytopenic purpura is characterized by a microangiopathic hemolytic anemia (confirmed by the presence of schistocytes
on the blood smear) and thrombocytopenia, but typically no other coagulopathy.
The presence of schistocytes
or "shift" reticulocytes in a peripheral blood smear could have pointed to in vivo hemolysis.
During the days following the initiation of plasma exchange, the patient's condition improved quickly with resolution of thrombocytopenia, normalization of haptoglobin and disappearance of schistocytes
A peripheral blood smear from the patient had 1 or 2 schistocytes
and 1 or 2 spherocytes per high-power field, a typical platelet morphology, and hyperlobated neutrophils.
A peripheral blood smear showed a marked hypochromic microcytosis with occasional schistocytes
, acanthocytes, and numerous elliptocytes.
Section II discusses the specifics of grading individual red blood cell abnormalities and defines a grading system described in words and images for anisocytosis, poikilocytosis, microcytosis, macrocytosis, hypochromia, polychromasia, blister cells, target cells, teardrop cells, schistocytes
, sickle cells, spherocytes, acanthocytes, echinocytes, elliptocytes, stomatocytes, Howell-Jolly bodies, basophilic stippling, Pappenheimer bodies, rouleaux, and agglutination.
Poikilocytosis is moderate to severe with burr cells, acanthocytes, and schistocytes
The presence of thrombocytopenia and schistocytes
(red cell fragments) at 1 per high power field on smear is commonly seen.
, burr cells, or helmet cells) on peripheral blood smear, acute renal injury (i.
In addition, erythrocytes are fragmented as they transverse small vessels narrowed by platelet aggregates, leading to hemolysis and the formation of schistocytes
Therefore, assessment of the blood smear for schistocytes
is warranted, along with coagulation studies, fibrinogen levels, and assays for fibrin split products and D-dimer.
MAHA is a form of anemia characterized by elevated reticulocyte count and serum lactate dehydrogenase (LD), decreased serum haptoglobin, and presence of schistocytes
(fragmented erythrocytes) on the peripheral blood film.
Review of peripheral blood smear reveals numerous schistocytes
Examination of a peripheral blood smear showed schistocytes
and other microangiopathic changes.