From the Research
Target cells on a blood smear are primarily caused by abnormalities in the red blood cell membrane, often resulting from liver disease, hemoglobinopathies, post-splenectomy states, or iron deficiency anemia, as indicated by the most recent and highest quality study available 1. These cells are characterized by a central area of hemoglobin surrounded by a pale ring and an outer rim of hemoglobin, resembling a target or bullseye. The presence of target cells can be attributed to various underlying conditions, including:
- Liver disease, such as hepatitis or cirrhosis, which alters the cholesterol and phospholipid content of the cell membrane
- Hemoglobinopathies, like sickle cell disease or thalassemia, which affect cell shape due to abnormal hemoglobin synthesis
- Post-splenectomy states, where the absence of splenic filtering allows abnormal cells to persist in circulation
- Iron deficiency anemia, which can lead to changes in red blood cell morphology Other potential causes of target cells include hyposplenism, severe iron deficiency, and certain medications that affect red cell membranes. The diagnosis and treatment of target cells depend on identifying and addressing the underlying condition, rather than the target cells themselves, as highlighted in recent studies 2, 1. It is essential to conduct further investigation to determine the primary cause of target cells on a blood smear, as treatment strategies vary depending on the underlying condition.