(a) Data set Training Validation Test Normal 728 81 203 Echinocyte 226 25 63 Dacrocyte 64 7 18 Schistocyte 546 61 152
Elliptocyte 66 7 18 Acanthocyte 120 13 33 Target cell 523 58 145 Stomatocyte 79 9 22 Spherocyte 173 19 48 Overlap 166 18 46 (a) Cells were randomly distributed 80:20 between training and test sets, respectively.
Mutations in the Band 3 gene (SLA4A1) result in red cell morphological abnormalities such as spherocytes (20 to 35 percent of hereditary spherocytosis cases) (7), ovalocytes, or
elliptocytes. Red cells become dehydrated and lose surface area-to-volume ratio which effects deformability.
However, the FBC and PBS findings of a low mean cell volume (MCV), as a result of the significant red cell fragmentation and the absence of
elliptocytes, suggested a diagnosis of HPP.
Peripheral smear showed
elliptocytes which were more than 50%, there was marked anisocytosis, poikilocytosis and red cell fragmentation (fig-1a).
Caption: FIGURE 1: Peripheral blood smear (Wright-Giemsa stained, 100x): peripheral smear showing anemia, with numerous
elliptocytes and thrombocytopenia.
(5,8) Also noted in the PBS image are a few
elliptocytes, oval or elliptical-shaped cells, seen in certain types of anemia.
Elliptocytes (Figure 3--Slide G) have elliptical shape and may reflect inherited defect (hereditary elliptocytosis).
HPP is characterized by erythrocyte poikilocytosis and fragmentation, erythrocyte budding, spherocytes, triangulocytes, micropoikilocytosis, microspherocytosis, and occasional
elliptocytes, which together result in a pattern reminiscent of thermal injury.
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.
Peripheral blood showed moderate macrocytosis with occasional microcytes,
elliptocytes and occasional teardrop cells.
In severe cases,
elliptocytes may accompany microcytes and hypochromic red cells on blood films.