Anisocytosis
The content of the article:
- Causes
- Kinds
- Signs
- Features of the course in children and pregnant women
- Diagnostics
- Treatment
- Prevention
Anisocytosis is the appearance in the general blood test of cells larger or smaller than normal in size. An increase or decrease in diameter in various pathological conditions is characteristic of erythrocytes.
A normal human erythrocyte is a non-nuclear biconcave cell of a round shape with a diameter of 6.8-7.7 microns (more often 7.2-7.5). Standard size red blood cells account for 70% of the total; the maximum allowable percentage of altered red blood cells is 30%.
Anisocytosis of platelets is much less common. Platelets are round (or rounded) non-nucleated formations, the so-called platelets. The average platelet size is 1-3 microns. The degree of deviation of platelet size from normal values varies within 14–17%, the presence of a larger number of altered platelets indicates pathology.
Anisocytosis is a pathological condition in which there is a change in the size of erythrocytes
Causes
Most often, anisocytosis accompanies the following conditions:
- Iron-deficiency anemia;
- sideroblastic anemia;
- B12 folate deficiency anemia;
- hypovitaminosis A;
- massive blood loss;
- blood transfusion;
- damage to the red bone marrow with changes in pluripotent stem cells;
- oncological diseases;
- chronic liver disease;
- pregnancy;
- hypothyroidism;
- some acute intoxication; and etc.
Kinds
Erythrocyte anisocytosis is classified according to the size of blood cells as follows:
- microcytosis (blood cell size less than 6.7 microns);
- macrocytosis (diameter more than 7.8 microns);
- megalocytosis (erythrocytes with a diameter of more than 12 microns);
- mixed anisocytosis (the presence of erythrocytes of various sizes in the blood).
Based on the percentage of altered cells from the total number of erythrocyte anisocytosis is divided according to the severity as follows:
- insignificant (micro-, macro- and megalocytes make up no more than 25% of the total mass of erythrocytes), in laboratory forms it is indicated as "+";
- moderate (the content of changed cells reaches 50%) - "++";
- pronounced (the number of altered erythrocytes significantly prevails over normal ones - from 50 to 75%) - "+++";
- critical anisocytosis - "++++" (there is a complete replacement of normal cells with altered).
Schizocytes and schizocytosis
Separately, there are such changes in laboratory parameters as schizocytosis (the presence in the peripheral blood of a large number of erythrocyte fragments 2–3 µm in size) and microspherocytosis (red blood cells are spherical, 4–6 µm in diameter).
Signs
Since the main function of red blood cells is to transport gases, the symptoms of anisocytosis are mainly determined by oxygen starvation of organs and tissues and are manifested as:
- progressive weakness;
- decreased performance;
- fast fatiguability;
- decreased ability to concentrate;
- inability to perform the usual physical activity;
- increased heart rate;
- dyspnea;
- pallor of the skin and mucous membranes;
- frequent headaches, episodes of dizziness;
- violations of the "sleep - wakefulness" regime (drowsiness, insomnia).
In addition, the clinical picture of anisocytosis is complemented by manifestations of the underlying disease.
Features of the course in children and pregnant women
Pronounced physiological macrocytosis is observed in newborns during the first 2 weeks of life, the blood count normalizes on its own within 1-2 months.
After the transferred infectious diseases in young children, reactive moderate anisocytosis is noted.
During pregnancy and breastfeeding, women sometimes have moderate microcytosis or, conversely, megalocytosis, which can signal the development of anemia.
Diagnostics
The main diagnostic criterion for anisocytosis is the presence of cells of uncharacteristic size in the general analysis of blood.
Blood test reveals cells of abnormal size
In rare cases, additional diagnostics are required - drawing up a Price-Jones histogram (distribution of red blood cells by diameter). The erythrocytometric curve in healthy people has a regular triangular shape with a high apex and a narrow base, erythrocytes with a diameter of 6-8 microns predominate, which make up 70-75% of all erythrocytes. Micro and macrocytes are found in approximately the same number (12-15%). The width of the erythrocytometric curve reflects the degree of anisocytosis, and the position of the maximum - the average diameter of the erythrocyte. With microcytosis, the curve shifts to the left, becomes asymmetric, and its width increases. With macrocytosis, the Price-Jones curve shifts to the right, flattens, its base expands.
Treatment
Since anisocytosis is a marker of a pathological process, and not an independent disease, its special treatment is not carried out.
If a large number of cells of an uncharacteristic size are found in the general blood test, the patient is recommended to consult specialists, instrumental and laboratory tests in order to clarify the diagnosis.
After identifying the cause of anisocytosis and making the correct diagnosis, specific therapy is prescribed:
- vitamin and iron preparations - for anemia;
- detoxification therapy;
- chemotherapy or radiation therapy - for oncological processes;
- thyroid medications;
- vitamin preparations; etc.
After successful treatment of the underlying disease, the phenomena of anisocytosis are eliminated.
Prevention
The development of anisocytosis can be prevented by observing preventive measures for the underlying disease that caused it.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
