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Schistocytes in disseminated intravascular coagulation
J-F Lesesve1, M Martin, C Banasiak
1Hematology laboratories at Nancy, Nancy, France.
International Journal of Laboratory Hematology
|November 23, 2013
Summary
Schistocytes, or fragmented red blood cells, are frequently seen in patients with disseminated intravascular coagulation (DIC). However, their presence, especially at low percentages, is not a definitive diagnostic marker for DIC.
Area of Science:
- Hematology
- Pathology
- Internal Medicine
Background:
- The diagnostic significance of schistocytes in disseminated intravascular coagulation (DIC) is debated.
- Schistocytes are fragmented red blood cells that can indicate various pathological conditions.
Purpose of the Study:
- To investigate the frequency and significance of schistocytes in patients diagnosed with DIC.
- To evaluate the utility of schistocyte counts in the diagnosis and management of DIC.
Main Methods:
- Peripheral blood films from 35 patients with DIC were analyzed for schistocyte presence and count.
- Morphological anomalies of all red blood cells (RBCs) were assessed.
- Correlation between schistocyte presence and clinical conditions was examined.
Main Results:
- Schistocytes were detected in 30 out of 35 DIC patients (85.7%).
- Acanthocytes were the most common RBC morphological anomaly observed.
- The mean schistocyte percentage was 0.33 ± 0.38%, with a median of 0.1% (range 0-1.4%).
- Higher schistocyte counts (≥ 1%) were associated with conditions like promyelocytic leukemia, pregnancy, and severe infections.
Conclusions:
- Schistocytes are commonly found in DIC patients, typically at low percentages (<0.5%), often within the normal reference range.
- Schistocyte counts are not a primary diagnostic tool for initial DIC diagnosis.
- Elevated schistocyte counts (≥ 1%) may indicate co-existing or underlying thrombotic microangiopathy.
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