Erythrocyte

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90% aged RBC destruction

Destruction of RBC is outside of the blood vessel

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Extravascular

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Thickness 1.5 to 2.5 um

Average volume 90 ul

Shape discoid or biconcave

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Erythrocyte

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Average lifespan is 120 days

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Erythrocyte

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How many number of erythrocytes produce from each pronormoblast

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16

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Ratio of RBC to WBC

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600:1

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Ratio of RBC to Platelets

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15:1

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Anaerobic glycolysis

Handles 90% of glucose

Generates ATP

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(EMP)

Embden Meyerhof Pathway

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Common enzymes deficiency of EMP

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Pyruvate Kinase (PK deficiency)

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Recommended screening test for PK deficiency

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PK fluorescents spot test

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Screening test for PK deficiency

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Autohemolysis test

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Confirmatory test for PK deficiency

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Quantitative PK assay

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Aerobically converts glucose to pentose

Produce NADPH

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(HMP)

Hexose Monophosphate Pathway

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Causes denaturation of globin which precipitates as aggregates

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Henze bodies

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Most common enzymes deficiency in Pentose phosphate pathway

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(G6PD)

Glucose- 6 phosphate Dehydrogenase

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Recommended screening test for G6PD deficiency

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G6PD fluorescent spot test

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Confirmatory test G6PD

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Quantitative G6PD assay

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Screening test for G6PD

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Autohemolysis test

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Generates 2,3 DPG(2,3 BPG biphosphoglycerate

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Rapport Leubering Pathway

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5 factors affinity of hemoglobin for oxygen

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PH

Partial pressure of CO2

Concentration of 2,3 DPG

Temperature

Presence of other hemoglobin species that are not functional

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What is the curve produce when 2 variables are ploted on graph

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oxygen dissociation curve

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Storage form of iron

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Ferritin

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Decrease 2,3 DPG

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Increase hemoglobin affinity to oxygen (shift to left)

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Increase 2,3 DPG

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Decrease hemoglobin affinity to oxygen ( shift right)

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It is the relationship between blood pH (hydrogen concentration) and 02 affinity of hemoglobin

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Bohr effect

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It is the binding of 02 to the hemoglobin promotes the release of CO2

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Haldane effect

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Codes for alpha and zeta globin chains

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Chromosomes 16

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Codes for beta, delta, epsilon, gamma globin chains

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Chromosomes 11

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Where does heme synthesis begins?

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Mitochondria

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Bound to oxygen

Carries by arteries

Gives pinkish to skin

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Oxyhemoglobin

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Unbound to Oxygen

Carries by veins

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Deoxyhemoglobin

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It has a typical brilliant CHERRY RED

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Carboxyhemoglobin

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It cause CHOCOLATE BROWN DISCOLORATION of blood

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Methemoglobin/hemiglobin

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Blood is MAUVE- LAVENDER

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Sulfhemoglobin

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Produce by the liver

Inactivates ferroportin

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Hepcidin

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90% aged RBC destruction

Destruction of RBC is outside of the blood vessel

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Extravascular

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10% aged Red cell destruction

Occurs when hemoglobin breaks down in the blood

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Intravascular

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Variation on cell size (RBC)

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Anisocytosis

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Normal size of RBC

6 to 8 um in diameter

MCV 80 to 100 fl

Conditions:

Acute blood loss

Hemolytic anemia

Aplastic anemia

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Normocytic RBC or

"discocyte'

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Smaller RBC than normal size

Conditions:Thalassemia

Sideroblastic anemia

Iron deficiency anemia

Anemia of chronic inflammation

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Microcytic RBC

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Large RBC than normal size

Conditions:

Megaloblastic Anemia

Reticulocytosis

Chronic liver diseases

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Macrocytic

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It is the variation of the color of erythrocytes cause by unequal hemoglobin concentration

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Anisochromia

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Mature RBCs with normal hemoglobin concentration and normal staining characteristics

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Normochromic RBC

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red blood cells have less hemoglobin than normal

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Hypochromic RBC

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RBC is more hemoglobin than normal

No central polar

Current terminology "SPHEROCYTES"

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Hyperchromic

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It is the variation/alterations in a shape of RBC

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Proikilocytosis

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Also called "Torn Cell"

Abnormal RBC with irregular spikes

Lacking of central polar

Increase in sphingomyelin over lecithin

Conditions:

Severe liver diseases

Pyruvate Kinase deficiency

Vitamin E deficiency

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Acanthocytes /Spur cells/ torn cells

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Also called "Burr Cell"

Small projection of Red cell membrane .

With central polar

Depletion of ATP exposure

Conditions:

Pyruvate Kinase deficiency

Hepatitis

Cirrhosis

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Echinocytes

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It is oval or "egg' like appearance

Conditions:

Vitamin B12 and folate deficiency

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Oval macrocytes/ "Megalocytes"

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a condition in which the bone marrow produces unusually large, structurally abnormal, immature red blood cells (megaloblasts).

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Megaloblastic Anemia

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Also called "Target Cell"

Resembles bull's eye

Appears as "Mexican hats"

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Codocytes

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A thinner variant of codocyte

Resembles target cell

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Leptocytes (or wafer cell)

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RBC that spherical rather than biconcave

Darker red color

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Spherocytes

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red cells with a slit-like or “fish-mouth” central pallor.

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Stomatocytes

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It is a "Cigar shape" RBC

It appears oval or elongated

Narrower than ovalocytes

Defect is considered to be in CYTOSKELETON

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Elliptocytes

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It is "Egg shape" RBC

Wider than elliptocytes

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Ovalocytes

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It s a "tear drop" or pear- shaped

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Dacrocyte

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It is a tiny round fragmented cells

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Microspherocytes or pyropoikilocytes

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It is a "pale pink ghost" of RBC

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Smilunar bodies / half moon / crescent cell

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Also called "Sickle cell"

It is a "Crescent shape cell"

Maybe curve or "S" shaped

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Depranocyte (Sikle cell)

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Inclusion bodies are

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Howell–Jolly bodies

Basophilic stippling

Cabot ring

Heinz bodies

Hemoglobin H bodies

Hemoglobin S crystals

Ring sideroblastic

Hemoglobin SC

Pappenheimer bodies

Etc

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Are remnants of RBC nuclei that are normally removed by the spleen.

Course round densely stain purple

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Howell-Jolly bodies

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It is round dark blue granules uniformly distributed , MULTIPLE PUNCTUATE BASOPHILIA

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Basophilic stippling

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Can be seen in lead poisoning

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Coarse stippling

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It is commonly seen when there is increase polychromatophilia

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Fine stippling

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threadlike ring- or “figure eight”

Resembles bead

Dark blue to purple

Remnant of microtubules of mitotic spindle

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Cabot ring

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Also called "Ehrlich bodies"

are inclusions within red blood cells composed of denatured hemoglobin

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Heinz bodies

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A multiple Heinz bodies it gives a cell the appearance of ;

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Pitted Glof Ball

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It results of splenic pitting of Heinz bodies

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Bite and Blister Cells

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It is described as " Golf balls" or "raspberries"

Due to accumulation of hemoglobin B chains

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Hemoglobin H bodies

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It is describe as" Gold bar" or Washington monument (Rodaks)

Clam shell

Homozygous hemoglobin C disease

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Hemoglobin C crystal

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It is described as "glove" or " pistol" Washington monument shaped

Double heterozygous hemoglobin SC

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Hemoglobin SC

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It contains non heme iron arrange in ring form

Excessive iron die to heme synthesis

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Ringed sideroblast

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Irregular clusters of small, light to dark blue granules, often near periphery of cell

Unused iron deposit

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Pappenheimer bodies

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Non nucleated cell containing iron

granules

Excessive iron overload in mitochondria due to defective heme synthesis

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Siderocyte

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It is associated with mitochondrial iron

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Sideroblastic anemia

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Plasmodium vivax inclusion

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Schuffner's dots

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Plasmodium falcifarum inclusion

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Maurer's dot

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Plasmodium malariae inclusion

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Zieman stippling (dots)

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Plasmodium ovale inclusion

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Schuffner's, James dots

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Protozoans transmitted by a bite of female anopheles mosquito

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Plasmodium spp (malaria)

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It is the most common cause of babesiosis in US

Originally called" NANTUCKET FEVER"

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Babesia microti

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It appears in a " Maltese cross" formation

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Babesia spp (babesiosis (

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Clumping of RBC

Presence of antibody and antigen reaction

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Auto agglutination

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Appear as " stacks of coins "

Increase concentration of abnormal globulin or fibrinogen

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Rouleax formation

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Howell - Jolly bodies

Visualization

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Wright stain

New Methylene blue

Fuelgen reaction (+)

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Basophilic stippling

Visualization

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Wright stain ( blue to purple)

Supravital stain

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Cabot ring

Visualization

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Wright stain

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Heinz bodies

Visualization

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Supravital stain

1. Methylene Blue

2. Brilliant Cresyl Blue

3. Methyl Violet

4. Crystal Violet

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Hemoglobin H Bodies

Visualization

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1. New Methylene Blue

2. Brilliant Cresyl Blue

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Ringed Sideroblast

Visualization

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1. Prussian blue

2. Wright stain

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Siderocyte

Visualization

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Prussian blue

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Pappenheimer bodies

Visualization

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1. Prussian Blue

2. Wright stain

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Hemoglobin is also known as

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Respiratory pigment

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Main components of RBC?

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95% cytoplasmic content RBC

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How many concentration of hemoglobin (hb)

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64,00 Dalton

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It is a plasma proteins that is able to save free hemoglobin

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Haptoglobin

Front 97

A protein that is able to to oxidase iron as it exits to the erythrocyte

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Hephaestin