Microangiopathic Hemolytic Anemia: Pathogenesis and Morphology

00:00 Now, TTP and HUS, TTP is to an adult as HUS is to a child.

00:06 In these conditions where the thrombi are present, what happens to your RBC? It get’s sheared.

00:12 By sheared, what that means they’re not called sheared cells.

00:17 Let me make that clear.

00:18 However, you can use the word sheared, meaning that it gets broken up or fragmented and you can use the term to then call them clinically on a peripheral blood smear as schistocyte.

00:31 Now, be careful.

00:32 Do not confuse these with bite cells.

00:34 Bite cells are something that we saw with G6PD deficiency.

00:38 And ultimately, maybe, you want to wear this schistocyte on your head.

00:43 What? A helmet cell is sometimes is what it’s referred as its nickname.

00:50 Schistocytes is what it’s called clinically and technically on your peripheral blood smear.

00:55 But do not confuse them with sickle cells, do not confuse them with bite cells.

01:00 Look for the history, history, history.

01:02 If your patient has been exposed to amniotic fluid emboli, DIC, without a doubt, that picture there is going to be a schistocyte of an RBC, not a sickle cell, you see what I’m saying? So go back to the history so that you are clear about what kind of RBC you’re looking at.

01:18 Do that always because you can never fully guarantee.

01:22 Now, what you find in your peripheral blood smear is only for that disease.

01:26 It gives you an approximation, I’ll give you that.

01:29 But you must confirm your finding by looking at the history and making sure that you’re able to confirm it.