What is the significance of elliptocytosis on a complete blood count (CBC)?

Elliptocytosis is not directly diagnosed on a complete blood count (CBC), but the CBC may show certain abnormalities that suggest this condition. Elliptocytosis is a hereditary disorder characterized by oval or elliptical-shaped red blood cells. On a blood count, you might see mild anemia with decreased hemoglobin and hematocrit levels, along with an elevated reticulocyte count indicating increased red blood cell production. However, the definitive diagnosis requires a peripheral blood smear examination where the characteristic elliptical red cells can be visualized. The percentage of elliptocytes in the blood smear helps determine the severity of the condition. Most patients with hereditary elliptocytosis are asymptomatic and require no treatment. For those with significant hemolysis and anemia, management may include folic acid supplementation (1 mg daily) to support increased red cell production, and in severe cases, splenectomy might be considered. The condition occurs due to mutations in genes coding for red blood cell membrane proteins, particularly protein 4.1, spectrin, or band 3, which lead to decreased membrane stability and the characteristic elliptical shape. Patients should be monitored periodically with CBC to assess for worsening anemia, especially during times of physiological stress or infection.