tailieunhanh - Chapter 058. Anemia and Polycythemia (Part 6)

Uremia. The red cells in uremia may acquire numerous, regularly spaced, small spiny projections. Such cells, called burr cells or echinocytes, are readily distinguishable from irregularly spiculated acanthocytes shown in Fig. 58-11. Figure 58-11 Spur cells. Spur cells are recognized as distorted red cells containing several irregularly distributed thornlike projections. Cells with this morphologic abnormality are also called acanthocytes. (From Hillman et al.) Reticulocyte Count An accurate reticulocyte count is key to the initial classification of anemia. Normally, reticulocytes are red cells that have been recently released from the bone marrow. . | Chapter 058. Anemia and Polycythemia Part 6 Figure 58-10 Sour l í ut AS. Mfptí DI. Br unw ld E. H ut rSL. Lança DU JL Loicatio Ji Miwtrolt s trf Iiittraii M àian . 17th Edition HttpiZ www . cc Copyrrflht Th MtQïiwHill Comp nni In . Ail nçhti ri rü d. Uremia. The red cells in uremia may acquire numerous regularly spaced small spiny projections. Such cells called burr cells or echinocytes are readily distinguishable from irregularly spiculated acanthocytes shown in Fig. 58-11. Figure 58-11 Source Fauci AS Kasper DL Braunwald E Hauser SL Longo DL Jameson JL. Loscalzo J Harrison s Principles of Interna Medicine 17th Edition http Copyright i ä The McGraw-Hill Companies Inc. All rights reserved. Spur cells. Spur cells are recognized as distorted red cells containing several irregularly distributed thornlike projections. Cells with this morphologic abnormality are also called acanthocytes. From Hillman et al. Reticulocyte Count An accurate reticulocyte count is key to the initial classification of anemia. Normally reticulocytes are red cells that have been recently released from the bone marrow. They are identified by staining with a supravital dye that precipitates the ribosomal RNA Fig. 58-12 . These precipitates appear as blue or black punctate spots. This residual RNA is metabolized over the first 24-36 h of the reticulocyte s lifespan in circulation. Normally the reticulocyte count ranges from 1-2 and reflects the daily replacement of of the circulating red cell population. A reticulocyte count provides a reliable measure of red cell production. Figure 58-12 Source Fauci AS Kasper DL Braunwald E. Hauser SL Longo DL Jameson JL Loscalzo J Principles of Interna Medicine 17th Edition http Copyright @ The McGraw-Hill Companies Inc. All rig hits reserved. Reticulocytes. Methylene blue stain demonstrates residual RNA in newly made red cells. From Hillman et al.