Schistocytes in disseminated intravascular coagulation

Int J Lab Hematol. 2014 Aug;36(4):439-43. doi: 10.1111/ijlh.12168. Epub 2013 Nov 22.

Abstract

Introduction: The presence of schistocytes on the peripheral blood film during disseminated intravascular coagulation (DIC) remains controversial.

Methods: We examined schistocytes count on blood films from 35 DIC patients and checked morphological anomalies of all RBCs.

Results: Thirty of 35 patients presented with schistocytes and 22 with acanthocytes, which was the commonest shape anomaly. Mean percentage ± standard deviation was 0.33 ± 0.38%, median value was 0.1%, and range was 0-1.4%. The patients with schistocytes ≥ 1% had circumstances frequently associated with increased schistocytes count (promyelocytic leukaemia, pregnancy, severe infection).

Discussion: Schistocytes were thus frequently observed in DIC patients, usually with low percentage, within or close to the reference range (<0.5%). Schistocytes measurement is not a clue test for the initial diagnosis of DIC, but might be of clinical value to suggest an associated or underlying thrombotic microangiopathy if ≥ 1%.

Keywords: Schistocyte; acanthocyte; disseminated intravascular coagulation; sepsis; thrombotic microangiopathy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cell Shape
  • Disseminated Intravascular Coagulation / complications
  • Disseminated Intravascular Coagulation / pathology*
  • Erythrocyte Count
  • Erythrocytes, Abnormal / pathology*
  • Female
  • Humans
  • Intensive Care Units
  • Leukemia, Promyelocytic, Acute / complications
  • Leukemia, Promyelocytic, Acute / pathology*
  • Male
  • Middle Aged
  • Shock, Septic / complications
  • Shock, Septic / pathology*
  • Thrombotic Microangiopathies / complications
  • Thrombotic Microangiopathies / pathology*