How to Treat RBC Morphology

Red blood cell morphology is not a disease or medical condition. Morphology refers to the various shapes that red blood cells can take. Pathologists are skilled in reading the shapes of red blood cells, to determine the health of a blood donor. Red blood cell morphology is also used to ascertain the presence of specific blood-borne diseases. Some of these conditions include sickle cell anemia, abetalipoproteinemia, bone marrow damage, hereditary elliptocytosis, megaloblastic anemia, iron deficiency anemia, hereditary stomatocytosis, malaria, myelofibrosis and thalassemia.

Things You'll Need

• Microscope

Show More

Instructions

• 1

  Conduct a visual inspection of the red blood cells (RBCs). Normal RBCs are round and appear in fairly equal size. Oval-shaped RBCs may mean a blood donor has alcohol-related liver disease, reticulocytosis, megaloblastic anemia, myelofibrosis, hereditary elliptocytosis -- or that they are healthy newborns. Myelofibrosis RBCs may also be teardrop-shaped. Sickle cell anemia cells are shaped like rods or boats.

• 2

  Measure the diameter of red blood cells. Normal RBCs normally have a diameter greater than 8 micrograms. Red blood cells that are thinner than 6.4 mcg are indicative of thalassemia, hyperthyroidism or iron deficiency anemia.

• 3

  Inspect the color of red blood cells. Pale red cells may indicate thalassemia, sideroblastic anemia or iron deficiency. Multi-color red blood cells tend to appear after patients undergo blood transfusions.

• 4

  Look for small RBC fragments. If they are irregularly shaped like triangles or spheres, these are red blood cells known as schistocytes. The presence of schistocytes are abnormal and possibly indicate elliptocytosis, burned tissue, megaloblastic anemia, hemolytic anemia and thrombotic thrombocytopenic purpura.

• 5

  Do not ignore red blood cell projections. They misshape normally round red blood cells. Multiple short projections of equal length are echinocytes. Echinocytes indicate electrolyte imbalances. Unequal length projections may represent a lecithin deficiency, or the presence of liver disease or uremia.

• 6

  Inspect the centers of red blood cells. Slit-shaped centers that are paler than the surrounding cell are RBCs known as stomatocytes. They are present in people with alcohol-related liver disease or hereditary stomatocytosis. Identifiable nuclei represent myelofibrosis, hemolytic anemia and chronic heart failure.

• 7

  Repeat complete blood count tests to confirm initial red blood cell morphology results. Red blood cells with an increased surface area, that maintain the same volume, may indicate an increase in cholesterol and/or lecithin.