schistocytosis

Schistocytosis is a medical term used to describe the presence of schistocytes in the peripheral blood smear. Schistocytes are irregularly shaped red blood cells that have been fragmented or broken into pieces. These fragments are typically smaller than normal red blood cells and can have a variety of shapes, including triangular, helmet-shaped, or crescent-shaped.

The formation of schistocytes is indicative of mechanical damage to red blood cells as they circulate through the bloodstream. This damage can occur in various clinical settings. One common cause is microangiopathic hemolytic anemia (MAHA), where small blood vessels become obstructed or damaged, leading to shear stress on red blood cells. Examples of MAHA include thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS).

Other conditions that can lead to schistocytosis include disseminated intravascular coagulation (DIC), certain types of prosthetic heart valves that can physically shear red blood cells, and severe burns. In some cases, schistocytosis can also be a transient finding following strenuous exercise or in individuals with severe iron deficiency anemia.

The identification of schistocytes on a blood smear is a crucial diagnostic clue that prompts further investigation into the underlying cause. The degree of schistocytosis can vary, and its presence often correlates with the severity of the underlying condition. Treatment strategies are directed at the specific cause of red blood cell fragmentation.