Spur cells seen in 3a). The formation of acanthocytes depends on the alteration of the lipid composition and fluidity of the red cell membrane. Spur cell RBC (Acanthocyte) May be smaller or the size of a normal RBC Irregular narrow-base sharp projections of red cell membrane (looking like cowboy boot spurs) Increased in: End stage Liver disease (Cirrhosis) Abetalipoproteinemia McLeod or Lu blood group phenotype Post-splenectomy Microangiopathic Hemolytic Anemia (as seen in DIC, TTP and Jan 17, 2024 · Acanthocytes (from the Greek word acantha, which means thorn), or spur cells, are spiculated red cells with a few projections of varying size and surface distribution (see the images below). It is often multifactorial, such as due to blood loss with or without coagulopathy, direct toxic effect of alcohol on hematopoietic cells, chronic inflammation, abnormalities in red blood cells (RBC) membranes, and nutritional deficiencies. More importantly, the vast majority of patients with high percentage of spur cells did not have severe anaemia. These red cells show spikes and shape more consistent with spur cells, typically seen in advanced liver disease. Striking burr and spur cell abnormalities are seen in this high oil magnification view of the Wright's stained peripheral blood in a patient with hepatorenal failure. The underlying cause can be attributed to various anemias, most commonly beta thalassemia major, a form of microcytic anemia. This article explains what type of anemia is spur cells seen in and details its relationship with advanced conditions like liver cirrhosis. Jan 17, 2024 · Acanthocytosis is a red cell phenotype associated with various underlying conditions. In Jul 24, 2023 · Severe liver dysfunction: Spur cell anemia (SCA) is a poorly studied clinical entity in liver disease, and its clinical importance remains as yet undefined. , FDP and D-dimer tests can be used to evaluate which of the following? A. Spur cells must be distinguished from echinocytes (Greek echinos, “sea urchin”) or burr cells, characterized by multiple small projections that are uniformly distributed throughout the cell surface (Fig. Spurs Neutrophils with a "liquid" cytoplasm are seen in severe inflammation. The spur cells have a smaller number of projections on a stalk. Projections are irregularly distributed around the cell membrane. Mar 2, 2023 · Abnormal red blood cell shapes (poikilocytes) Providers categorize abnormal red blood cell shapes based on their features. Abdominal ultrasound revealed a nodular liver and splenomegaly of 15. Sep 18, 2025 · Explore the mechanisms and significance of burr cells, acanthocytes, and target cells in identifying systemic disorders related to red blood cell membrane. Acanthocytes (spur cells): Seen in liver disease, thalassemia, abetalipoproteinemia, splenectomized patients, autoimmune hemolytic anemia, kidney disease, and Mcleod syndrome. 45. Studies in acanthocytosis workup include a complete blood count (CBC) and a peripheral blood smear. These RBCs may be seen in some peripheral smears due to artifacts or may be associated with certain conditions including Abetalipoproteinemia, Liver disease, Malnutrition, Hypothyroidism, Asplenia, and McLeod Jul 24, 2023 · When remodeled by the spleen in liver disease patients, acanthocytes develop more blunt spicules and become relatively more spherocytic; these are known as spheroacanthocytes or ‘spur cells. Peripheral smear from a 77-year-old man with alcoholic cirrhosis shows multiple acanthocytes (50x). The presence of burr cells can be an indication of various underlying conditions, including hematological malignancies, infections, and other diseases 2. Diagnostic Significance: Acanthocytes may occur in dogs and cats with liver, splenic, or renal disorders. Formally, a distinction is made between echinocytes (10-30 regular protrusions) and acanthocytes (<20 irregular, pointed protrusions), but this is often very difficult in practice. Seen above: Macrocytes (larger) Polychromasia (blue-purple) Acanthocytes (spurs) Echinocytes (burrs) Spherocytes Microcytes (smaller) Schistocytes Poikilocytosis refers to the presence of abnormally shaped red blood cells on a blood film. Learn the causes, symptoms, and treatment options for this condition. Oct 14, 2022 · Spur cell anaemia (SCA) is a specific form of haemolytic anaemia reported in patients with advanced cirrhosis. They are usually accompanied by other signs of activation such as hypergranulation. Central pallor is absent. g. These cells may also occur as artifact. Why: These cells indicate abnormal hemoglobin content or structural integrity. In bleeding ulcers. Seen exclusively in end stage liver disease, particularly in the setting of alcoholic cirrhosis. We postulated that even in the absence of spur-cells, cholestasis might alter red blood cell (RBC) osmotic fragility and deformability. (37823455) (Further discussion on blood smear: ) Jan 1, 2009 · A history of alcoholism and liver disease combined with current findings of enlarged spleen, hemolytic anemia, and a peripheral blood smear showing spiculated red cells are consistent with spur cell anemia. Wherever possible, the red blood Chronic anemia is common in liver cirrhosis. Spur cells have increased membrane cholesterol, increased cholesterol-to-phospholipid ratio, and membrane rigidity. Liver disease Acanthocytes (Spur Cells) are most commonly associated with Heel Spur Syndrome Treatment Options As board certified foot and ankle specialists, heel pain is the most common condition we see. This page includes the following topics and synonyms: Erythrocyte Morphology on Peripheral Smear, Erythrocyte Morphology, Red Blood Cell Morphology, Macrocyte, Microcyte, Spherocyte, Elliptocyte, Schistocyte, Acanthocyte, Spur Cell, Dacryocyte, Howell-Jolly, Target Cell, Basophilic Stippling, Sideroblast, Cabots Ring Bodies. What is the absolute retic count? and more. Oct 27, 2015 · Acanthocytes (also called spur cells) are spiculated cells with irregular, pointed or clublike projections that are unevenly distributed on the cell surface. Historically, spur cell anemia has been associated with advanced alcoholic liver cirrhosis, but it is also seen in other types of severe liver disease. The abnormal hemoglobin causes deformity of the red blood cells into crescent or sickle-shapes, as seen in this photomicrograph. SCA has been re … Jan 17, 2024 · Acanthocytes (from the Greek word acantha, which means thorn), or spur cells, are spiculated red cells with a few projections of varying size and surface distribution (see the images below). 0 license and was authored, remixed, and/or curated by Valentin Villatoro and Michelle To (Open Education Alberta) via source content that was edited to the style and standards of the LibreTexts platform. Acanthocyte/ SPUR CELL 5-10 irregular spicules VARYING LENGTH SPUR SPUR SPUR IMBALANCE BETWEEN RBCS AND PLASMA LIPIDS ALCOHOLIC LIVER DISEASE, POST SPLENECTOMY, Abetaliproteinemia Rare Spur cells may be seen in a blood smear which may be due to the very old RBCs that are reaching their end of life. Indeed, spur cells are not typically seen in patients with Zieve syndrome. May 15, 2025 · Acanthocytosis is when you have abnormally shaped red blood cells called acanthocytes. For example, additional cell membrane loss can blunt the spicules, and the acanthocytes become spherocytic, as seen in patients with severe liver disease. Read on. Jun 21, 2004 · The spike-like projections on the spur cells are more evident on this higher-power view. Acanthocytes (Spur Cells) Distinctive Features: Acanthocytes are RBCs with multiple, irregular projections that are randomly spaced. Note the loss of central pallor and the presence of multiple spicules. It is associated with high mortality. Bite cells reflect oxidant injury (generally G6PD deficiency). The term used to indicate red blood cells of normal size and shape is normocytic. Spur cell anemia lacks landmark features of Zieve syndrome such as fever and abdominal pain. Peripheral blood smear (panel A) revealed spur cells (acanthocytes, arrows). spur cell anemia anemia in which the erythrocytes are acanthocytes (spur cells) and are destroyed prematurely, primarily in the spleen; it is an acquired form occurring in severe liver disease in which there is increased serum cholesterol and increased uptake of cholesterol into the erythrocyte membrane, causing the abnormal shape. Acanthocytes should also be distinguished from keratocytes (“horn” red cells) that have few massive protuberances. Aug 5, 2023 · Although the cells above could be similar to schistocytes, their shape is not consistent with a rupture of a red blood cell as it occurs in thrombotic microangiopathy. It gets diagnosed with the following: Hb is less than10 mg/dl, hemolysis, over 5% spur cells on PBS, and the exclusion of other causes of anemia. Causes of acanthocytosis include severe liver disease and rare genetic conditions. [2] Acanthocytosis has also been associated with inherited neurologic disorders, aptly named Spur cells may refer synonymously to acanthocytes, [6] or may refer in some sources to a specific subset of 'extreme acanthocytes' that have undergone splenic modification whereby additional cell membrane loss has blunted the spicules and the cells have become spherocytic ('spheroacanthocyte'), as seen in some patients with severe liver disease. We present the case of a 57-year-old woman with alcoholic cirrhosis who presented with symptomatic macrocytic anemia with a hemoglobin level of 7. Jan 1, 2023 · Spur cell anemia (SCA) is an acquired form of non-autoimmune hemolytic anemia that occurs in advanced liver disease. May 11, 2024 · Image by kjpargeter on Freepik Red blood cells are the predominant cells seen in a peripheral smear in normal conditions. Aug 6, 2025 · Spur cells (an extreme form of acanthocyte seen in severe liver disease) Intravascular hemolysis due to Clostridium perfringens sepsis Peripheral smear in microangiopathic hemolytic anemia showing presence of schistocytes Red cell fragmentation ("Waring blender syndrome") due to defective heart valve. The list below and the accompanying infographic spur cells Acanthocytes characteristics "spur cells" - UNEVEN projections/spicules - seen in cirrhosis of the liver Apr 1, 2007 · Aim: Spur cell anemia (SCA) is a form of acquired hemolytic anemia seen in patients with advanced cirrhosis and particularly in patients with alcoholic cirrhosis. Heel spur syndrome, also known as Plantar Fasciitis, is a chronic, overuse type injury that occurs in people of all shapes and sizes, of all ages and activity levels. They result from alterations in membrane lipids and The term “poikilocyte” is a generic or umbrella term to describe erythrocytes with abnormal shape. Normal mature RBC are biconcave, round discs that are about 6 – 8 in diameter, which is only slightly smaller than the normal small mature lymphocytes ( about 6 – 10 in diameter). There is no universal acceptance of the number of acanthocytes required to diagnose spur cell anemia, but most studies call for at least 20% of the red cells seen on the peripheral smear. Anticoagulant rodenticide toxicity, The These cells also must be distinguished from the acanthocyte that is seen in hereditary acanthocytosis and terminal liver failure (spur cell anemia). 7). Poikilocytosis is the presence of an increased number of abnormally shaped red blood cells. SCA is usually defined by the presence of spur cell rate of ≥5%, although there remains a lack of consensus in the definition. This page titled 2. Spur cell hemolytic anemia, Chronic liver disease impairs the liver's ability to esterify cholesterol, causing free cholesterol to bind to the red cell membrane, increasing its surface area without increasing its volume. Artifact - can be caused by hypertonic solutions or drying artifacts during slide preparation. It is characterized by the presence of acanthocytes or spur cells, spiculated erythrocytes whose shortened life span causes anemia that is unresponsive to transfusion. Sep 18, 2024 · Anisopoikilocytosis is a medical condition characterized by a variation in the size and shape of red blood cells. It most commonly develops without an injury and results in significant pain in the heel or arch of Jul 24, 2019 · A 42-year-old white man presented with jaundice and generalized edema. Acanthocytes contrast to echinocytes in that acanthocyte projections are randomly spaced, and echinocyte projections are regularly spaced. Teardrop cells (dacrocytes): myelophthistic processes (especially myelofibrosis), myelodysplasia, megaloblastic anemias, thalassemia major. In most cases, we have opted to use the more specific name for each abnormally shaped red blood cell in place of the term poikilocytosis. He had been diagnosed with alcoholic cirrhosis four months prior. Clinical disorder: severe liver disease causing coagulopathy and spur cell (acanthocytic) anaemia. Target cells comprise from 5% to 30% or even more of the red cells; nucleated red cells and shift erythrocytes may be seen. Laboratory evaluation is summarized in the Table. The acanthocyte differs from the echinocyte and the burr cell; it is characterized by a small spherocytic center with long thorny projections. 2: Acanthocytes (Spur Cells) is shared under a CC BY-NC 4. Spur cell anemia is a serious disorder in cirrhotic patients and is associated with poor prognosis. They have a biconcave shape with peripheral hemoglobinization and a central clear zone of pallor. ’ Issues of Concern Register For Free And Read The Full Article Get the answers you need instantly with the StatPearls Clinical Decision Support tool. ” They can be seen in advanced liver disease (where they are referred to as spur cells), abetalipoproteinemia, and, occasionally, after splenectomy. Management of Learn about blood morphology, including normal and abnormal red and white cells, platelets, and their clinical significance in hematology. Alcohol-induced liver Spur cell anaemia (SCA) is a specific form of haemolytic anaemia reported in patients with advanced cirrhosis. Changes detected in red blood cells can indicate infections, neoplasia, poisoning, or metabolic disorders and help guide the choice of additional diagnostic tests. Hyperlipidemia: Only 50% of patients are lipemic at the time of diagnosis. SCA has been classically associated with alcohol-related cirrhosis but can be seen across the spectrum of cirrhosis and acute to chronic liver failure. This image also shows examples of the teardrops and schistocytes which can be seen in thalassemia trait. We see that although cell area increases uniformly along the entire spur during development (electronic supplementary material; figure S5), cell anisotropy varies along the length of the spur (figure 3b,c). [1][2] A more common term for these cells is burr cells. 6 cm in craniocaudal dimension. The presence of acanthocytes in the blood is associated with hemolytic anemia, myelodysplastic syndromes, splenectomy, and hereditary abetalipoproteinemia. These cells are most often a feature of hyposplenism but also occur in liver failure, when the term “spur cell hemolytic anemia” has been used. Study with Quizlet and memorize flashcards containing terms like rouleaux formation, howell-jolly bodies, bite cells; schistocytes; keratocytes (helmet cells) and more. Study with Quizlet and memorize flashcards containing terms like Normal red blood cells, Anisocytosis, Microcytosis and more. Poikilocytes can be subclassified according to specific shape changes, some of which have fairly unique diagnostic significance, while other forms are quite non-specific. Acanthocyte: Spur cells with irregular projections, seen in liver disease, abetalipoproteinemia, and lipid disorders. If you see crenated cells in only one area of the slide or if EVERY cell is crenated, it is most likely artifact and does not indicate any pathologic state. Multiple acanthocytes in a 49-year-old man with cirrhosis. Dimorphic RBC populations include 2 variations of shape. In thalassemia, cells with coarse basophilic stippling are frequently seen. Read this article to know more about the condition in detail. Oct 22, 2025 · The meaning of SPUR CELL is acanthocyte. (100x, oil). Both types of cells Cell Description: Red blood cells appear small and dense, lacking an area of central pallor with multiple spiky projections (spicules) of varying lengths protruding from the membrane. Jan 16, 2025 · Acanthocytosis Acanthocytosis means you have acanthocytes in your blood. Spur cell is seen in severe liver diseases Burr cells These are irregularly contracted red cells. These deformed neutrophils can be seen, for example, in sepsis. Sep 5, 2015 · This topic covers all the morphological abnormalities that a red blood cell can undergo. We present the case of a 57-year-old woman with alcoholic cirrhosis who presented with Learn about Burr cells (echinocytes) in this lesson. Burr Cells What's the Difference? Acanthocytes and Burr Cells are both types of abnormal red blood cells that can be seen in certain medical conditions. Spur cells or acanthocytes are large red blood cells (RBCs) with spike-like projections resulting in deformed shape and flexibility, which predispose them to sequestration and destruction in splenic canaliculi. Acanthocytes have irregularly shaped, spiky projections on their surface, giving them a thorny appearance, while Burr Cells have small, evenly spaced projections that give them a scalloped or serrated edge. Generally, the bur cells or echinocytes have a more even distribution over the surface of the red blood cell. May 29, 2020 · Spur cell anemia is an acquired hemolytic anemia associated with liver cirrhosis and is characterized by the presence of increased large red blood cells, which are covered with spike-like projections that vary in width, length, and distribution. The change in morphology is related to derangements in the lipid or protein composition of the RBC membrane which Burr cells occur in which conditions? Uremia (kidney failure) - most commonly. Spiculated RBC has a rough surface or crenated in shape and is seen in: Uremia. Echinocytes (also called burr cells) have regular spicules and are more commonly seen in renal disease but can also be observed in liver disease as in this case. Study with Quizlet and memorize flashcards containing terms like Acanthocytosis, also known as Spur Cell is an RBC with irregular thorn-like projections. (Note: life span of an RBC is ~ 4 months) Nov 8, 2020 · Acanthocytes (spur cells): Seen in liver disease, thalassemia, abetalipoproteinemia, splenectomized patients, autoimmune hemolytic anemia, kidney disease, and Mcleod syndrome. The aim of the present study was to evaluate the incidence of spur cells and spur cell anemia in patients with advanced liver disease and to correlate the presence of spur cell anemia with survival. She was found to have nonimmune hemolytic anemia with acanthocytes, or spur cells, on a peripheral-blood smear. Before we start with the abnormal morphologies, let’s talk about normal morphology of Red Blood Cells. What are the RBC staining or color abnormalities Anisocytosis: Variation in RBC shape may include larger, smaller, teardrop-shape, acanthocytes (look like spurs), echinocytes (look like burrs), oval-shape, etc as seen in the slide above. Acanthocytosis and Echinocytosis Acanthocytes, or spur cells, are red cells with multiple irregularly shaped and randomly distributed cytoplasmic projections (see Figure 61. spur cell (plural spur cells) (hematology) A pathological, irregularly spiked red blood cell without central pallor. Liver diseases. This report highlights the importance of management and treatment strategies, including control of fluid retention, blood transfusion, plasma diafiltration, and administration of diuretics. The literature on the entity has not been systematically reviewed, despite the classical association and frequent association with worse outcomes. Defects that cause an imbalance May 2, 2017 · Spur cells, or acanthocytes, are large erythrocytes covered with spikelike projections that vary in width, length, and distribution (see image below). As seen in the literature, the treatment of spur cell anemia without liver transplantation is quite challenging. Spur cell anemia (SCA) is an acquired form of non-autoimmune hemolytic anemia that occurs in advanced liver disease. Acanthocytes, or spur cells, are red cells with multiple irregularly shaped and randomly distributed cytoplasmic projections (see Figure 23. Understand Burr cells causes and their structure. Study with Quizlet and memorize flashcards containing terms like Anisocytosis, Poikilocytosis, Disocyte and more. Jul 8, 2023 · Furthermore, spur cells refer to a subset of extreme acanthocytes in which splenic modifications occur. Methods: During a 33-month period 11 Variations in shape and distribution of erythrocytes Poikilocytosis is a general term for the presence of abnormally shaped red blood cells. Sep 1, 2006 · Acanthocytes are red cells that have a spherical core and a spiculated appearance. 1,2 There are diverse aetiologies for anaemia in cirrhosis and frequently multiple causes co-exist. Patient with a heart valve prosthesis. {file44196} {file44197}The cells appear contracted, dense, and irregular. You generally don't need to aim for a perfect report, because for most purposes, a peripheral smear is a relatively simple screening test, and clinicians may opt to perform for example flow cytometry and/or a bone marrow biopsy if they want a better evaluation. Here is a table that summarizes the main characteristics of a normal red blood cell: Multiple RBC abnormalities could be observed in a peripheral smear and can point toward certain conditions that could be present. Unlike normal red blood cells, acanthocytes have uneven spiky projections on their membranes. Erythrocyte ghosts reveal intravascular hemolysis, especially due to clostridial bacteremia. Jan 26, 2022 · A 48-year-old woman with advanced cirrhosis presented with fatigue. Sep 16, 2024 · Spur cells (acanthocytes) imply spur cell anemia. Boxed cell is shown at higher magnification in inset (100x, oil). Echinocytes should be differentiated from acanthocytes (also called spur cells), which have more irregular projects and are more commonly found in liver disease. 30 × 1012/L and a reticulocyte count of 4%. These cells appear as a "target" with a peripheral ring of hemoglobin and a central area of hemoglobin. These cells can be differentiated from the echinocytes (burr cells) that are seen in uremia or liver disease by the presence of more uneven, irregular projections. These abnormal erythrocytes are seen in a b-lipoproteinemia, amyotrophic chorea (chorea-acanthocytosis), McLeod syndrome (Kell antigen defects), cystic fibrosis, anorexia nervosa, severe liver disease, and hypothyroidism [222–226 Spur cells (acanthocytes): severe liver disease, abetalipoproteinemia, malabsorption. Visible organisms may reveal malaria, babesia, or Bartonella. Quick guide Below is a summary of terms used to describe red blood cell morphologic features, the meaning of the term and associated interpretation (the provided list of diseases is not exhaustive). There are a wide variety of red cell morphological changes which may suggest various hereditary or acquired conditions. Jul 24, 2023 · Excerpt The membrane of red blood cells (RBCs) can undergo a variety of changes leading to morphologic alterations in these cells. Parul Bhargava, MD Joan Etzell, MD William Finn, MD In contrast to white blood cells, circulating erythrocytes are anucleate and normally homogeneous in appear-ance. Evaluation of red blood cell morphology is an important part of a CBC. May 1, 2023 · Anaemia is a commonly encountered complication in patients with chronic liver disease and cirrhosis and is seen in 53–66% of the patients. Study with Quizlet and memorize flashcards containing terms like _ bodies are areas of denatured hemoglobin that appear as clear zones in mature red blood cells stained with Wright's stain. Additional Conditions: Iron deficiency anemia, post-splenectomy states. Echinocytes cells are erythrocytes with multiple protrusions due to disruption of the cell membrane. May 2, 2017 · The presence of spur cells in peripheral blood (acanthocytosis) is a common feature of a heterogeneous variety of acquired and inherited disorders. 1-3 Cell Formation: Acanthocyte formation occurs as a result of either hereditary or acquired membrane defects. These are seen in : Renal diseases. These cells are at risk of being broken down faster than your body can replace them with normal cells. Other RBC abnormalities include target cells, RBC fragments Target cells are also called codocytes. Acanthocytes form as a result of membrane lipid abnormalities, and can be seen in liver disease, neuroacanthocytosis, severe malnutrition, and abetalipoproteinemia. Moreover, Zieve syndrome is transient and reversible, whereas spur cell anemia is progressive and portends a high short-term mortality. The upper images show acanthocytosis in a patient with drug-induced acute liver failure (all images May–Grunwald–Giemsa, ×100 objective). Nov 1, 2020 · Spur cell haemolytic anaemia (SCA) is a form of anaemia that can be seen in patients with severely impaired liver function or advanced cirrhosis. See an acanthocytes vs Burr cells comparison Mar 2, 2016 · Acanthocytes (also called spur cells) are spiculated cells with irregular, pointed or clublike projections that are unevenly distributed on the cell surface. - altered lipid metabolism, hepatic lipidosis, hemangiosarcoma in older dogs with regenerative anemia. A peripheral blood smear showed numerous spur cells. May 30, 2023 · Spur cell anemia is a serious condition associated with liver cirrhosis patients. Learn Nov 1, 2020 · Spur-cell anemia is associated with a poor prognosis, and liver transplant is the only definitive management. The term poikilocyte is a generic or umbrella term to describe erythrocytes with abnormal shape. The etiology of anemia in liver cirrhosis is multifactorial; one less recognized cause is hemolytic anemia due to spur cells, known as spur cell anemia. Mar 28, 2019 · The acanthocytes (spur cells) seen here result from impaired lipid metabolism associated with liver failure. Sort the following clinical features according to the syndrome: Terrible prognosis Self-liming (reversible) Abdominal pain Hyperlipidemia Progressive Mild-moderate cirrhosis Fatty liver Acanthocytes End stage liver disease Few or no acanthocytes Zieve syndrome Spur cell Study with Quizlet and memorize flashcards containing terms like How would you differentiate between an acanthocyte and an echinocyte?, An instrument printout indicates an MCV of 63 fl and an MCHC of 26 g/dl. One fish cell is seen at the center of Figure 1. N, neutrophil; L, lymphocyte (100x, oil). We can subclassify poikilocytes by specific shape changes, some of which have fairly unique diagnostic significance, while other forms are quite non-specific. 2 Supportive management includes transfusion for symptomatic anemia, discontinuation of bone marrow-suppressive medications and alcohol, and appropriate treatment for the primary cause of liver disease. Apr 2, 2025 · Burr cells, also known as echinocytes, are abnormal red blood cells that can be seen on a blood smear 2. How to use spur cell in a sentence. Defects that cause an imbalance Feb 24, 2016 · Acanthocytes (spur cells) are spiculated red cells with a few projections of varying size and surface distribution. 11. Dec 1, 2023 · Background Spur-cell anemia sometimes accompanies cholestasis. It is associated with poor prognosis and a high 90-day mortality (3). Tertiary hemostasis C. Where they are seen Learn with flashcards, games, and more — for free. The biconcave cell shape allows for erythrocyte movement through even the smallest capillaries, while hemoglobin carries oxygen for Nov 2, 2023 · Anemia in patients with alcohol use disorder (AUD) has a wide range of differential diagnoses, which can be challenging to interpret. In our study, spur cell anaemia (spur cells >5%) was found in almost 10% of outpatient cirrhotics and was significantly related to more decompensated disease, higher incidence of ACLF and 1 year liver-related mortality. The liter-ature on the entity has not been systematically reviewed, despite the classical association and frequent association with worse outcomes. They’re associated with rare inherited conditions as well as more common acquired conditions. May 20, 2022 · INTRODUCTION Some red blood cell (RBC) disorders affect the shape of the cells by altering the plasma membrane composition or the ratio of plasma membrane to intracellular volume. A diagnosis of sp May 2, 2017 · Spur cells, or acanthocytes, are large erythrocytes covered with spikelike projections that vary in width, length, and distribution (see image below). Absence of spur cells and end stage cirrhosis as well as the presence of hyperlipidemia distinguish Zieve syndrome from spur cell anemia. Burr cells (one shown with arrow) in a 67-year-old woman with chronic kidney disease. Spur cell anemia (SCA) has shown to be associated with advanced liver disease; however, it is generally under-reported [3 - 5]. Post-splenectomy. Spur cells can be encountered in acquired or inherited disorders. 3A). Acanthocytosis may be inherited (autosomal recessive) in association with retinitis pigmentosa, diffuse neurological deficits, and abetalipoproteinemia. A 26-year-old man was referred to our hospital presenting with jaundice, lower limb edema, and dyspnea. The term used to indicate May 2, 2017 · The presence of spur cells in peripheral blood (acanthocytosis) is a common feature of a heterogeneous variety of acquired and inherited disorders. A) True B) False, What area of the blood smear slide you need to be when viewing RBC morphology? A) Feathered edge B) Heel C) Critical area D Mar 10, 2022 · Updated: Mar 10 2022Pathologic RBC Forms Red Blood Cell Morphologic Changes in Hemolytic AnemiasIn these topics Overview of Hemolytic Anemia > a spiculated red blood cell with 5-10 spiny projections of varying length distributed irregularly over the cell surface; seen in patients with liver disease and abetalipoproteinemia. 4 g/dL and signs of decompensated liver disease. The patient was subsequently diagnosed with Dec 13, 2024 · The name comes from the Greek, άκανθα, meaning thorn. It can be part of a physical or used to diagnose disease. Primary (mechanical) hemostasis B. Nov 29, 2022 · Author: Mikael Häggström [note 1] Look at and comment separately on white blood cells, red blood cells and platelets. Secondary (chemical) hemostasis D. First, SCA is observed in very advance liver disease patients and can also be seen in nonalcoholic cirrhotic. Acanthocytosis Acanthocytes, or spur cells, are red cells with multiple irregularly shaped and randomly distributed cytoplasmic projections (see Figure 23. These abnormal erythrocytes are seen in αβ-lipoproteinemia, amyotrophic chorea (chorea acanthocytosis), McLeod syndrome (Kell antigen defects), cystic fibrosis, anorexia nervosa, severe liver disease, and Aug 22, 2018 · A 31-year-old man with cirrhosis presented with confusion and anemia. Spur cell anemia can mimic Zieve syndrome except for a few unique features. Hospital course was complicated Study with Quizlet and memorize flashcards containing terms like AKA Spur Cells: - irregular, spiculated RBCs with a few unevenly distributed surface projections of variable length and diameter. Nov 7, 2025 · Affecting a significant percentage of patients with severe liver disease, spur cell anemia is characterized by the presence of red blood cells with thorny projections called spur cells. A complete blood count is a simple and fast test routinely performed as a basic part of a health assessment. The presence of acanthocytes in the urine indicates glomerular damage. The Greek word acanthos means thorn. acanthocyte, keratocytes, echinocytes, and the Jul 14, 2024 · Target Cell: RBCs with a bullseye appearance, often seen in liver disease, thalassemia, and hemoglobinopathies. (Note: life span of an RBC is ~ 4 months) Feb 19, 2020 · Acanthocytes are abnormal red blood cells that have irregular spikes on the cell surface. Learn more about what causes it, symptoms of poikilocytosis, and more. Wherever possible, the red blood cell shape should be identified specifically, e. , Acanthocytes (Spur cells), AKA Burr Cells & Crenated Cells - Spiculated cells with numerous short Spur cell anemia (SCA) is a rare cause of acquired hemolytic anemia seen in advanced liver cirrhosis. When viewed under a freshly prepared peripheral blood smear (PBS), acanthocytes appear as cells with a few spicules of different sizes, projecting from the surface of the RBC membrane at irregular intervals. Acanthocytes are Mar 9, 2013 · Fish cells resemble teardrop cells, with one rounded end and one tapered end: unlike teardrops, the tapered end flares out into two buds resembling a fish's tail. Mar 27, 2021 · Acanthocytes, or spur cells, consist of characteristic spicules seen on peripheral smear. These abnormal erythrocytes are seen in a b-lipoproteinemia, amyotrophic chorea (chorea-acanthocytosis), McLeod syndrome (Kell antigen defects), cystic fibrosis, anorexia nervosa, severe liver disease Sickle cell anemia is an inherited blood disease in which the red blood cells produce abnormal pigment (hemoglobin). Why: Due to Acanthocytes Spur cells A type of dysmorphic red blood cell characterized by irregular, thorn-like cytoplasmic projections. Cell Description: Red blood cells appear small and dense, lacking an area of central pallor with multiple spiky projections (spicules) of varying lengths protruding from the membrane. Nov 3, 2024 · A blood smear test provides information about the number and shape of your blood cells. With poikilocytosis, you may have one or more of the following abnormal cells, or poikilocytes: Acanthocytes (spur cells): Cells with spikes of different lengths and widths jutting outside the cell membrane. Jul 19, 2025 · Poikilocytosis is the presence of abnormal shaped red blood cells. Seen in severe liver disease patients regardless of the etiology, it is known to portend an Acanthocytes form as a result of membrane lipid abnormalities, and can be seen in advanced liver disease where they are referred to as spur cells, neuroacanthocytosis, severe malnutrition, abetalipoproteinemia and occasionally, after splenectomy 1. 2 The presence of anaemia has been linked to increased complications and a worse prognosis in cirrhosis. The mechanism is thought to be alteration of lipid metabolism on the erythrocyte membrane, leading to the characteristic morphology that has a propensity for hemolysis. Liver transplantation Jan 31, 2022 · Acanthocytes, or spur cells, are morphologically altered red blood cells (RBCs) with spiculated projections of varying size and surface distribution that are usually seen in patients with severe liver dysfunction, abetalipoproteinemia, post-splenectomy and hypothyroidism. Multiple acanthocytes in a 56-year-old woman with cirrhosis. Three of the most common morphologies are burr cells (echinocytes), acanthocytes, and target cells. Acanthocytes (from the Greek word acantha, which means thorn), or spur cells, are spiculated red cells with a few projections of varying size and surface distribution (see the images below). It includes detail of the morphological abnormality, diseases that cause it, and tips to identify it. This cell type may be seen in a variety of conditions including liver disease, sickle cell disease, thalessemias, and iron deficiency anemia. A typical acanthocyte lacks central pallor and has from 3 to 12 “spikes” or “knobs. Rare Spur cells may be seen in a blood smear which may be due to the very old RBCs that are reaching their end of life. May 2, 2017 · Spur cells, or acanthocytes, are large erythrocytes covered with spikelike projections that vary in width, length, and distribution (see image below). Echinocyte (from the Greek word echinos, meaning 'hedgehog' or 'sea urchin'), in human biology and medicine, refers to a form of red blood cell that has an abnormal cell membrane characterized by many small, evenly spaced thorny projections. 2,3 Spur cell anaemia (SCA) is a specific form of Two irregularly contracted red cells (blue arrow) in a 30-year-old splenectomized man with pyruvate kinase deficiency. Acanthocytes vs. Note the short, blunt projections distributed evenly around the circumference of the cell, and the retention of some central pallor (100x, oil). SCA has been regarded as a rare condition with an ominous prognosis for which the only known cure is liver Shown at slightly higher power there are again numerous acanthocytes, the distortion in this case reflects more widespread damage to red cells as part of the generalised illness of this patient. Apr 20, 2024 · This post is an answer to the Case – Patient with Cirrhosis and Anemia A peripheral-blood smear showed red cells lacking central pallor with irregularly distributed surface projections, features that are consistent with acanthocytes, or spur cells (arrowheads), which are seen in liver disease, in abetalipoproteinemia, and after splenectomy. In this setting, the pathogenesis of anemia is complex and multifactorial. Jan 17, 2024 · Acanthocytes (from the Greek word acantha, which means thorn), or spur cells, are spiculated red cells with a few projections of varying size and surface distribution (see the images below). How will the red cells appear under the microscope?, A patient sample has an RBC count of 4. [2] Acanthocytosis has also been associated with inherited neurologic disorders, aptly named Study with Quizlet and memorize flashcards containing terms like The variation in the shape of red blood cells is called: A) Anisocytosis B) Poikilocytosis C) Acanthocytes D) Shape shifters, Poikilocytosis is common in small ruminants, especially goats. Fragmented cells are seen in : DIC. Looks like 'Cowboy Boot Spurs'.