From the Guidelines
The blood smear results showing unremarkable RBC morphology are consistent with a normal finding, and no specific action is required based on this result alone. The absence of red blood cell poikilocytosis, schistocytes, or other abnormalities suggests that there are no underlying conditions such as anemia, hemoglobinopathies, or other blood disorders that would affect the red blood cells 1. According to the study on idiopathic thrombocytopenic purpura (ITP) published in the journal Blood 1, normal red blood cell morphology is consistent with the diagnosis of ITP, but in this case, it simply indicates that the red blood cells appear normal. Some key points to consider when interpreting this result include:
- The "Final" status indicates that the laboratory has completed their analysis and verified these findings.
- This type of blood smear examination is typically part of a complete blood count (CBC) and helps healthcare providers assess for various blood disorders by examining the appearance of blood cells under a microscope.
- While this particular result is normal, it should be interpreted in the context of other laboratory findings and the patient's clinical presentation, as recommended by the American Society of Hematology 1. The study 1 provides guidance on the peripheral blood smear in ITP, but the normal RBC morphology in this case does not necessarily indicate ITP or any other specific condition.
From the Research
RBC Morphology Analysis
- The analysis of RBC morphology is a crucial aspect of laboratory hematology diagnosis, particularly in patients with anemia 2.
- A peripheral blood smear examination can provide valuable information on RBC shape, size, color, inclusions, and arrangement, which can aid in establishing a differential diagnosis 2.
- Abnormalities in RBC morphology can be indicative of various conditions, such as microcytic anemia, normocytic anemia, and macrocytic anemia 2.
Blood Smear Scan and Examination
- A blood smear scan is necessary to verify flagged automated hematology results and determine if a manual differential leukocyte count needs to be performed 3.
- Blood smear examination, including manual differential leukocyte count with complete blood count (CBC), provides a complete hematologic picture of the case from a morphologic standpoint 3.
- Blood smear review with or without interpretation ensures that no clinically significant finding is missed and can provide diagnosis or diagnostic clues, particularly when interpreted by a physician 3.
Standardization of Nomenclature and Grading
- The International Council for Standardization in Haematology (ICSH) recommends standardizing the nomenclature and grading of peripheral blood cell morphological features to ensure consistent reporting of blood cells worldwide 4.
- The guidelines provide information on how to reliably and consistently report abnormal red blood cells, white blood cells, and platelets using manual microscopy 4.
Analysis of Red Blood Cells from Peripheral Blood Smear Images
- The analysis of red blood cells from peripheral blood smear images can aid in the detection of anemia, which is a significant public health concern affecting 1.62 billion people worldwide 5.
- Automated image processing techniques can be used to analyze the characteristics of RBC from PBS images, providing a robust and inexpensive method for detecting RBC disorders 5.
COVID-19 and RBC Morphology
- Studies have shown that RBC morphological abnormalities can occur in patients hospitalized for COVID-19, with a certain degree of abnormalities observed in 65% of patients 6.
- The presence of RBC morphological abnormalities has been associated with a higher mortality rate and more consistent lymphopenia and thrombocytopenia in COVID-19 patients 6.