Dacryocytes are a common morphologic feature of autoimmune and microangiopathic haemolytic anaemia
-
Christoph Robier
,
Daniela Klescher
Abstract
Background: Dacryocytes are teardrop-shaped erythrocytes which are most frequently observed in peripheral blood smears of patients with primary or secondary myelofibrosis as well as malignant infiltrative disorders of the bone marrow. Dacryocytes have rarely been described in blood smears of patients with autoimmune (AIHA) and microangiopathic haemolytic anaemia (MAHA). The clear prevalence of dacryocytes in AIHA and MAHA is unknown.
Methods: We compared the dacryocyte counts in blood smears stained according to the May-Grünwald-Giemsa technique between 20 subjects with AIHA and MAHA with those from 21 controls. The dacryocytes, defined as erythrocytes tapered to a point at one end, were counted as cells per 20 high power fields (HPF) at 630-fold magnification.
Results: In AIHA, MAHA and controls, dacryocytes were found in 89%, 91% and 19% of the slides, respectively. The rate of dacryocyte positivity and the dacryocyte counts between haemolytic anaemias and controls differed statistically highly significant (p<0.0001).
Conclusions: The results of this study indicate that dacryocytes are commonly apparent in blood smears of patients with AIHA and MAHA. Knowledge of this frequent feature may be beneficial in clinical routine diagnosis.
References
1. Bain BJ. Morphology of blood cells. In: Blood cells. A practical guide, 4th ed. Blackwell Publishing, 2006:76–7.10.1002/9780470987551Search in Google Scholar
2. Tefferi A. Primary myelofibrosis: 2013 update on diagnosis, risk-stratification, and management. Am J Hematol 2013;88:141–50.10.1002/ajh.23384Search in Google Scholar PubMed
3. Bain BJ. Diagnosis from the blood smear. N Engl J Med 2005;353:498–507.10.1056/NEJMra043442Search in Google Scholar PubMed
4. Bunyaratvej A, Sahaphong S, Bhamarapravati N, Wasi P. Quantitative changes of red blood cell shapes in relation to clinical features in beta-thalassemia/HbE disease. Am J Clin Pathol 1985;83:555–9.10.1093/ajcp/83.5.555Search in Google Scholar PubMed
5. Dani SU. Osteoresorptive arsenic intoxication. Bone 2013;53:541–5.10.1016/j.bone.2013.01.017Search in Google Scholar PubMed
6. Kawahara S, Morimoto K, Nakazawa H, Kumagai T, Saito T, Aikawa S, et al. Severe hemolytic anemia with tear drop cells as initial manifestation of Wilson’s disease. Rinsho Ketsueki 1998;39:665–9.Search in Google Scholar
7. Farolino DL, Rustagi PK, Currie MS, Doeblin TD, Logue GL. Teardrop-shaped red cells in autoimmune hemolytic anemia. Am J Hematol 1986;21:415–8.10.1002/ajh.2830210410Search in Google Scholar PubMed
8. Oztürkmen S, Pac A, Senayl A, Polat TB, Cetin II, Bcakc Z, et al. Schistocytic hemolytic anemia owing to central venous catheter in a child with acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2010;32:e233–5.10.1097/MPH.0b013e3181e003e2Search in Google Scholar PubMed
9. Zini G, d’Onofrio G, Briggs C, Erber W, Jou JM, Lee SH, et al. ICSH recommendations for identification, diagnostic value, and quantitation of schistocytes. Int J Lab Hematol 2012;34: 107–16.10.1111/j.1751-553X.2011.01380.xSearch in Google Scholar PubMed
10. Ford J. Red blood cell morphology. Int J Lab Hematol 2013;35:351–7.10.1111/ijlh.12082Search in Google Scholar PubMed
11. Gütgemann I, Heimpel H, Nebe CT. Significance of tear drop cells in peripheral blood smears. J Lab Med 2013;37: 227–31.Search in Google Scholar
12. DiBella NJ, Silverstein MN, Hoagland HC. Effect of splenectomy on teardrop-shaped erythrocytes in agnogenic myeloid metaplasia. Arch Int Med 1977;137:380–1.10.1001/archinte.1977.03630150076021Search in Google Scholar
13. Chang CS, Li CY, Liang YH, Cha SS. Clinical features and splenic pathologic changes in patients with autoimmune haemolytic anemia and congenital haemolytic anemia. Mayo Clin Proc 1993;68:757–62.10.1016/S0025-6196(12)60633-8Search in Google Scholar
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Editorial
- Personalized medicine: moving from simple theory to daily practice
- Evaluating and using innovative technologies: a lesson from Theranos?
- Review
- Emerging biomarkers in the detection and prognosis of prostate cancer
- Mini Review
- Could molecular assessment of calcium metabolism be a useful tool to early screen patients at risk for pre-eclampsia complicated pregnancy? Proposal and rationale
- Opinion Papers
- Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe
- Theranos phenomenon: promises and fallacies
- Clinical laboratories: production industry or medical services?
- Genetics and Molecular Diagnostics
- Role of JAK2 V617F mutation and aberrant expression of microRNA-143 in myeloproliferative neoplasms
- Direct identification of Gram-positive bacteria and resistance determinants from blood cultures using a microarray-based nucleic acid assay: in-depth analysis of microarray data for undetermined results
- General Clinical Chemistry and Laboratory Medicine
- Comparison between bottom-up and top-down approaches in the estimation of measurement uncertainty
- Role of vitamin D and sFlt-1/PlGF ratio in the development of early- and late-onset preeclampsia
- Adenosine deaminase, dipeptidyl peptidase-IV activities and lipid peroxidation are increased in the saliva of obese young adult
- PON-1 and ferroxidase activities in older patients with mild cognitive impairment, late onset Alzheimer’s disease or vascular dementia
- Comparison of five automated hematology analyzers in a university hospital setting: Abbott Cell-Dyn Sapphire, Beckman Coulter DxH 800, Siemens Advia 2120i, Sysmex XE-5000, and Sysmex XN-2000
- Dacryocytes are a common morphologic feature of autoimmune and microangiopathic haemolytic anaemia
- Performance characteristics of a new automated method for measurement of anti-cyclic citrullinated peptide
- The clinical performance of a chemiluminescent immunoassay in detecting anti-cardiolipin and anti-β2 glycoprotein I antibodies. A comparison with a homemade ELISA method
- Reference Values and Biological Variations
- Reference interval for immature platelet fraction on Sysmex XN hematology analyzer: a comparison study with Sysmex XE-2100
- Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day
- Cancer Diagnostics
- Urinary miR-183 and miR-205 do not surpass PCA3 in urine as predictive markers for prostate biopsy outcome despite their highly dysregulated expression in prostate cancer tissue
- Cardiovascular Diseases
- Elevated circulating levels of lipoprotein-associated phospholipase A2 in obese children
- Letters to the Editors
- Reporting of hemolysis index (HI) with laboratory results should be obligatory in newborns and infants
- Unmeasurably high chloride: a surrogate marker of thiocyanate poisoning identification
- Association between red cell distribution width and myocardial infarction in rheumatoid arthritis
- Plasmatic and urinary glycosaminoglycan profile in a patient affected by multiple sulfatase deficiency
- Rapid diagnosis of cryptococcal meningitis by Türk staining
- A high selectivity and sensitivity analytical method for the analysis of 8-hydroxy-2′-deoxyguanosine in the urine of Alzheimer’s disease patients
- S100B protein concentration measurement according to two different immunoassays
Articles in the same Issue
- Frontmatter
- Editorial
- Personalized medicine: moving from simple theory to daily practice
- Evaluating and using innovative technologies: a lesson from Theranos?
- Review
- Emerging biomarkers in the detection and prognosis of prostate cancer
- Mini Review
- Could molecular assessment of calcium metabolism be a useful tool to early screen patients at risk for pre-eclampsia complicated pregnancy? Proposal and rationale
- Opinion Papers
- Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe
- Theranos phenomenon: promises and fallacies
- Clinical laboratories: production industry or medical services?
- Genetics and Molecular Diagnostics
- Role of JAK2 V617F mutation and aberrant expression of microRNA-143 in myeloproliferative neoplasms
- Direct identification of Gram-positive bacteria and resistance determinants from blood cultures using a microarray-based nucleic acid assay: in-depth analysis of microarray data for undetermined results
- General Clinical Chemistry and Laboratory Medicine
- Comparison between bottom-up and top-down approaches in the estimation of measurement uncertainty
- Role of vitamin D and sFlt-1/PlGF ratio in the development of early- and late-onset preeclampsia
- Adenosine deaminase, dipeptidyl peptidase-IV activities and lipid peroxidation are increased in the saliva of obese young adult
- PON-1 and ferroxidase activities in older patients with mild cognitive impairment, late onset Alzheimer’s disease or vascular dementia
- Comparison of five automated hematology analyzers in a university hospital setting: Abbott Cell-Dyn Sapphire, Beckman Coulter DxH 800, Siemens Advia 2120i, Sysmex XE-5000, and Sysmex XN-2000
- Dacryocytes are a common morphologic feature of autoimmune and microangiopathic haemolytic anaemia
- Performance characteristics of a new automated method for measurement of anti-cyclic citrullinated peptide
- The clinical performance of a chemiluminescent immunoassay in detecting anti-cardiolipin and anti-β2 glycoprotein I antibodies. A comparison with a homemade ELISA method
- Reference Values and Biological Variations
- Reference interval for immature platelet fraction on Sysmex XN hematology analyzer: a comparison study with Sysmex XE-2100
- Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day
- Cancer Diagnostics
- Urinary miR-183 and miR-205 do not surpass PCA3 in urine as predictive markers for prostate biopsy outcome despite their highly dysregulated expression in prostate cancer tissue
- Cardiovascular Diseases
- Elevated circulating levels of lipoprotein-associated phospholipase A2 in obese children
- Letters to the Editors
- Reporting of hemolysis index (HI) with laboratory results should be obligatory in newborns and infants
- Unmeasurably high chloride: a surrogate marker of thiocyanate poisoning identification
- Association between red cell distribution width and myocardial infarction in rheumatoid arthritis
- Plasmatic and urinary glycosaminoglycan profile in a patient affected by multiple sulfatase deficiency
- Rapid diagnosis of cryptococcal meningitis by Türk staining
- A high selectivity and sensitivity analytical method for the analysis of 8-hydroxy-2′-deoxyguanosine in the urine of Alzheimer’s disease patients
- S100B protein concentration measurement according to two different immunoassays
