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Pseudopyropoikilocytosis: a striking artefact

B J Bain1, R Liesner

  • 1Department of Haematology, St Mary's Hospital Medical School, London.

Insights

Blood films showing budding erythrocytes and microspherocytes can indicate hereditary pyropoikilocytosis or thermal burns. This artifact can also result from overheating during transport, potentially causing diagnostic confusion.

Area of Science:

  • Hematology
  • Pathology
  • Medical Diagnostics

Background:

  • Hereditary pyropoikilocytosis and severe thermal burns present with characteristic blood film morphologies, including budding erythrocytes and microspherocytes.
  • These morphological changes are critical diagnostic indicators in specific clinical contexts.

Observation:

  • A novel observation details similar blood film abnormalities arising from iatrogenic overheating during blood sample transport.
  • This artifact mimics pathological changes, highlighting the impact of pre-analytical variables on blood smear morphology.

Findings:

  • The study identifies overheating of blood specimens as a cause for budding erythrocytes and microspherocytes.
  • This finding expands the differential diagnosis for these red blood cell morphologies beyond inherited conditions and severe burns.

Implications:

  • Recognizing this transport-induced artifact is crucial to prevent misdiagnosis of hereditary pyropoikilocytosis or thermal injury.
  • Awareness can avert unnecessary patient testing and associated inconvenience, improving diagnostic efficiency.

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