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Anisochromia: Difference between revisions

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(Created page with " '''Derivation:''' ''From latin “fasten with glue”'' ---- '''Description''' Erythrocytes linked together to form irregular clumps of varying size. <gallery mode="nolines" widths="240px" heights="240px" border="1px" > File:RC_C_agglutination_G.png|link={{filepath:RC_C_agglutination_G.png}} File:RC_F_Agglutination_G.jpg|link={{filepath:RC_F_agglutination_G.jpg}} </gallery> <span style="font-style:italic; font-size:90%;'' > '''Appearance:''' The key points a...")
 
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'''Derivation:''' ''From the Greek Aniso (unequal) and Greek Chromia (referring to colour or shade)''


'''Derivation:''' ''From latin “fasten with glue”''
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'''Description'''  
'''Description'''  


Erythrocytes linked together to form irregular clumps of varying size.
This is a simple term that describes variation of colour between the red cells on blood smears; the term does not imply the nature of that variation or a pathological cause – just that different red cell have a different shade!






<gallery mode="nolines" widths="240px" heights="240px" border="1px" >
<gallery mode="nolines" widths="240px" heights="240px" border="1px" >
File:RC_C_agglutination_G.png|link={{filepath:RC_C_agglutination_G.png}}
File:RC_C_anisochromia_G.png|link={{filepath:RC_C_anisochromia_G.png}}
File:RC_F_Agglutination_G.jpg|link={{filepath:RC_F_agglutination_G.jpg}}
File:RC_F_anisochromia_G.jpg|link={{filepath:RC_F_anisochromia_G.jpg}}
</gallery>
</gallery>




<span style="font-style:italic; font-size:90%;'' >
<span style="font-style:italic; font-size:90%;'' >
'''Appearance:'''  The key points are that the red cell groups are very irregular. In many cases they will include cells that have been damaged by the underlying immunological process (shown in the cartoon image as a spherocyte and irregularly contracted cell with the agglutinated group). A small image from a clinical case is shown for comparison.
'''Appearance:'''  Variability in colour can have many causes, these two images show normochromic, hypochromic and polychromatic cells together in the same image.
</span>
</span>


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'''Significance'''
'''Pitfalls'''
 
 
The main pitfall is that the term is selected to describe the appearances of a film but falls short of describing what is happening: cells that may contribute to variation in color may include: dense hyperchromic erythrocytes, hypochromic erythrocytes, reticulocytes or stippled cells – these should be identified individually.
 
 
'''Recommendation'''
 
The term is better avoided when used alone: it is generally more useful to indicate the precise types of cells present. The example images show films that could be described as “anisochromic”, but note that in each case there are more specific terms that describe the cell types that contribute to the appearance.
 
 
 
'''Gallery'''
 
 
<span style="font-style:italic; font-size:90%;'' >
'''''Clinical Image 1:'''  Variation in colour and size in this image is caused by a combination of severe hypochromia, polychromasia, and partial transfusion.  Clinical condition: Partly treated severe thalassaemia (hydrops)''
</span>
 
 
<gallery widths="250px" heights="250px" >
File:Anisochromia_1.jpg|link={{filepath:Anisochromia_1.jpg}}
</gallery>
 


Agglutinates arise when antibodies attach to antigens on the membranes of adjacent red cells linking them together. The most common cause is "cold-reactive" IgM antibodies which do not cause overt symptoms. However, in some cases the effects may be clinically significant since antibodies may activate complement causing haemolysis, or the agglutinated cells can cause occlusion of small blood vessels in the cold (acrocyanosis). The clumped cells will sediment more rapidly leading to a raised erythrocyte sedimentation rate (ESR). Finally, the antibodies that cause cold agglutination may indicate an underlying malignancy (particularly lymphoma), or by acute infection.
<span style="font-style:italic; font-size:90%;'' >
'''''Clinical Image 2:'''  The variable colour in this case reflects a dimorphic blood film with hypochromic and transfused cells - more accurately described as dimorphic.  Clinical condition: transfused severe iron deficiency.''
</span>
 
 
<gallery widths="250px" heights="250px" >
File:Anisochromia_2.jpg|link={{filepath:Anisochromia_2.jpg}}
</gallery>
 
 
 
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Latest revision as of 14:38, 23 March 2023

Derivation: From the Greek Aniso (unequal) and Greek Chromia (referring to colour or shade)



Description

This is a simple term that describes variation of colour between the red cells on blood smears; the term does not imply the nature of that variation or a pathological cause – just that different red cell have a different shade!




Appearance: Variability in colour can have many causes, these two images show normochromic, hypochromic and polychromatic cells together in the same image.



Pitfalls


The main pitfall is that the term is selected to describe the appearances of a film but falls short of describing what is happening: cells that may contribute to variation in color may include: dense hyperchromic erythrocytes, hypochromic erythrocytes, reticulocytes or stippled cells – these should be identified individually.


Recommendation


The term is better avoided when used alone: it is generally more useful to indicate the precise types of cells present. The example images show films that could be described as “anisochromic”, but note that in each case there are more specific terms that describe the cell types that contribute to the appearance.


Gallery


Clinical Image 1: Variation in colour and size in this image is caused by a combination of severe hypochromia, polychromasia, and partial transfusion. Clinical condition: Partly treated severe thalassaemia (hydrops)



Clinical Image 2: The variable colour in this case reflects a dimorphic blood film with hypochromic and transfused cells - more accurately described as dimorphic. Clinical condition: transfused severe iron deficiency.