Related Experiment Video
Updated: Sep 11, 2025
11:27
Prediction of Red Blood Cell Antibody Significance Using the Monocyte-Macrophage Assay
Published on: February 7, 2025
616
Double Bite Cells in Oxidative Hemolytic Anemia
Jacob R Anderson1,2, Marie A Hollenhorst2,3
1Internal Medicine Resident Physician, Stanbury Physician-Scientist Pathway, Massachusetts General Hospital, Boston, Massachusetts, USA.
American Journal of Hematology
|August 13, 2025
Summary
Double bite cells on blood smears indicate oxidant hemolysis from recreational alkyl nitrite use. This diagnosis was confirmed in a patient with normal glucose-6-phosphate dehydrogenase (G6PD) levels.
Area of Science:
- Hematology
- Toxicology
Background:
- Oxidant hemolysis is a serious condition that can result from exposure to certain substances.
- Recreational alkyl nitrite use is known to cause various health issues, including hemolysis.
Observation:
- A patient presented with findings suggestive of hemolysis.
- Peripheral blood smear examination revealed the presence of characteristic 'bite cells'.
Findings:
- The presence of bite cells strongly suggested oxidant hemolysis.
- The patient's hemolysis was directly linked to recreational alkyl nitrite use.
- Crucially, the patient had normal glucose-6-phosphate dehydrogenase (G6PD) levels, ruling out a common genetic predisposition.
Implications:
- This case highlights the diagnostic utility of peripheral blood smear findings in alkyl nitrite-induced oxidant hemolysis.
- It underscores that G6PD deficiency is not a prerequisite for this type of hemolysis.
- Clinicians should consider alkyl nitrite exposure in patients presenting with unexplained hemolysis, even with normal G6PD status.
Related Concept Videos
01:27Disorders of Erythrocytes
1.2K
Disorders of erythrocytes, or red blood cells (RBCs), include a range of conditions affecting their number, shape, or function.
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
1.2K
01:24Hemoglobin
4.4K
Hemoglobin is a globular protein made up of four subunits. Two of these subunits are alpha chains, and the other two are beta chains. Each subunit contains a molecule of heme, which has an iron atom and can bind to oxygen. When an oxygen molecule binds to one heme group, it changes the shape of hemoglobin, making it easier for the other heme groups to bind oxygen as well.
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
4.4K
01:14Erythropoiesis
4.8K
Red blood cells (RBCs) transport oxygen to all body tissues. These cells survive only for 120 days and then need to be replenished. Erythropoiesis is the process of RBC production. In healthy individuals, erythropoiesis ensures all tissues are amply supplied with oxygen. In addition, blood loss due to injury leads to a drop in the physiological oxygen level that will cause erythropoiesis. Any defect in erythropoiesis leads to several physiological disorders, including thalassemia, anemia,...
4.8K
01:22Lifecycle of Erythrocytes
2.3K
Erythrocytes, also known as red blood cells, constantly move through blood capillaries. As a result, they damage their plasma membrane due to the continuous friction. Typically, after 100 to 120 days, erythrocytes become rigid and fragile as they wear out. As they pass through small vessels in the spleen and liver, they can get trapped and break apart into fragments.
The resident phagocytic macrophages deal with these damaged cells by engulfing them and separating their globin and heme groups....
The resident phagocytic macrophages deal with these damaged cells by engulfing them and separating their globin and heme groups....
2.3K
02:20Blood Types
18.3K
Human blood is classified into different types based on the presence of antigens on the red blood cell's surface and antibodies in the plasma. Proper identification of blood type is essential for successful blood transfusion. The International Society of Blood Transfusion has identified 38 human blood types based on the surface antigens on the red blood cells. The most common types are ABO, Rh, and MNS blood types.
ABO blood group
ABO antigens are glycoproteins encoded by genes present on...
ABO blood group
ABO antigens are glycoproteins encoded by genes present on...
18.3K
01:10Blood Typing
1.5K
Understanding an individual's blood group is a critical component of transfusion medicine. It ensures compatibility in blood transfusions, organ transplants, and even during pregnancy. Determining these blood groups involves the ABO and Rh blood typing systems, utilizing specific antigens and corresponding anti-sera to identify an individual's blood type.
Antigens are protein molecules that reside on the surface of red blood cells (RBCs). The ABO and Rh blood typing systems target...
Antigens are protein molecules that reside on the surface of red blood cells (RBCs). The ABO and Rh blood typing systems target...
1.5K