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Hematology/Why does my blood look like this


QUESTION: Hi, could you explain why my blood should look like this, four days ago my blood was Rouleau, now four days later it looks all spiky.

Thank you for taking the time to look at these pictures.

Regads Stuart

ANSWER: Hello Stuart,
Warm welcome to you!
Are you a student of hematology?
Are both pics belong to same blood smear? or you prepared smear again after 4 days?

The spiky cells are called echinocytes/burr cells. It could be just an artifact of rbc taking up stain abnormally or due to the drying of smear.

Pathologically its seen in following conditions:

iron deficiency
anemia due to blood loss or hemolysis
malabsorption states
after administration of heparin
pyruvate kinase deficiency
phosphoglycerare kinase deficiency
snake bite, etc.

Thanking you!

---------- FOLLOW-UP ----------

QUESTION: Good Morning, no I'm not student of hematology, I just have a interest parasitology, I keep Bearded Dragons and two Ball Pythons, the two picture's are taken about four days apart and no stains were used, could the echinocytes/burr cells be caused by isopropyl swab not evaporating before taking the blood sample.
I'm also diabetic but diet controlled my age is 61 and I am on a blood thinning agent, is their anything that I shout be concerned about as my doctor says not to worry about it.

Once again thank you for you time.  

Regards Stuart

Its not because of isopropyl, the blood thinning agent you are taking can make burr cells appear on blood smear. Yes as your doctor has said, you dont need to be worried about it. Its a normal reaction to anti-coagulants in some individuals. If your other lab reports are normal, that is sufficient.

Thanking you!


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Dr.Shrinidhi Kulkarni


I can answer all questions related to hematology. RBC, WBC, Platelet and blood forming organs etc and related questions. hematology also includes blood proteins, hemoglobin and disorders related to clotting abnormalities. So questions about all aspects of hematology are welcome!


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KIMS Banglore

MBBS, Internship in Internal Medicine

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