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What is Poikilocytosis ?


Poikilocytosis is a rare medical condition where people have abnormally shaped red blood cells (RBCs) in their blood cells. People affected with these disease have increased amount of poikilocytes in their blood which are basically red blood cells that are of various shapes.

Usually red blood cells are round and flat, resembling a disk. However, a person having poikilocytes can carry RBCs which are flatter than normal or elongated. In some occasions they have been found to be teardrop shaped which pointy projections.

This blood disorder could be fatal. The primary objective of red blood cells in our body is to carry oxygen and nutrients to tissues and organs. Because of their odd share they can be unable to carry enough oxygen which can lead to severe health issues.

This image shows different types of Poikilocytosis cells that are found in the blood pictures

Image 1: This image shows different types of Poikilocytosis cells that are found in the blood
Photo Source: ehealthhall.com

This image depicts the phenomenon Poikilocytosis where red blood cells are abnormally shaped Poikilocytosis pictures

Picture 2: This image depicts the phenomenon Poikilocytosis where red blood cells are abnormally shaped
Photo Source: d1yboe6750e2cu.cloudfront.net

Causes of Poikilocytosis

This rare disease is mainly caused by other health issues. There can be both inherited and acquired causes of Poikilocytosis.

Inherited causes

  • Sickle cell anemia: This is a genetic deformation where RBCs are found to of crescent shape.
  • Thalassemia: In this genetic disorder human body tends to produce abnormally shaped hemoglobin.
  • McLeod syndrome: Your nerves, heart and blood could get affected by this rare disorder.
  • Hereditary elliptocytosis and hereditary spherocytosis can also cause this disease.

Acquired causes

  • Iron deficiency anemia: This sickness occurs due to lack of iron in body.
  • Megaloblastic anemia: This disease is caused by lack of vitamin B-12 in the body.
  • Autoimmune hemolytic anemia: In this rare disease, the immune system in our bodies start destroying RBCS.
  • Other factors like alcoholism, lead poisoning and chemotherapy can also cause Poikilocytosis.

The primary cause of the disease remains nutrient deficiency. As Vitamin B12 plays a major part in absorption of folic acid, lack of vitamin B12 and folic acid can lead to abnormal shapes of red blood cells.

However, lack of folic acid and iron in the blood can also be caused by medical conditions such as celiac disease, tropical sprue and regional enteritis.

Types of Poikilocytosis

Depending on the structure of the red blood cell, Poikilocytosis can be classified in many different types. There is a possibility of having different type of Poikilocytosis present in the blood stream at the same time.

  1. Spherocytes: They are small, dense round cells that could be caused by hereditary spherocytosis, anemia or red cell fragmentation disorders.
  2. Stomatocytes: These RBCs are elliptical or mouth shaped. Alcoholism, liver disease and hereditary stomatocytosis are thought of as possible causes.
  3. Codocytes: These cells are called target cells as they resemble a bullseye. Cholestatic liver disease, thalassemia and hemoglobin C disorder are the main cuase of this type of Poikilocytosis.
  4. Sickle Cells: These are crescent-shaped and elongated RCBS.
  5. Leptocytes: These thin, flat cells with hemoglobin at the edge of the cell are most common in people with thalassemia.
  6. Ovalocytes: These cells are slightly oval and indicate a medical condition called ereditary elliptocytosis.
  7. Dacryocytes: They are teardrop shaped cells which are found in people diagnosed with thalassemia and leukemia.
  8. Spur cells: these cells have thorny projections. Causes of this disease include abetalipoproteinemia, neuroacanthocytosis and severe liver diseases.
  9. Burr cells: These blood cells have evenly spaced projections on the edge of the cell membrane. Kidney diseases, ulcer and cancer can cause this condition.
  10. Schizocytes: They are fragmented RBCS which are found in people with anemia.

Diagnosis and treatment of Poikilocytosis

To diagnose Poikilocytosis doctors usually order different teats. Blood film test is conducted as the primary test to detect abnormal RBCs. This test will help identify the type of Poikilocytosis. After conducting this, you have to go for a differential blood count which will count the number of abnormal RBCs in your blood.

Later blood composition test and hemoglobin tests will be conducted to verify the amount of enzymes and hemoglobin count in the blood.

Treatment of Poikilocytosis mainly includes getting enough amounts of vitamin B12 and B9. Eating meat products, soy products, eggs, lentils, almonds, beets, spinach, cabbage, broccoli, and whole grains can help to improve amount of folic acid in your body. However chemotherapy can be applied as a treatment for this disease too.


Anisocytosis is a rare medical condition where people have red blood cells that are unequal in size in their blood streams. This disease is very common after people suffer from anemia, thalassemia or any other blood disorder. This is mainly caused by lack of iron in blood cells which leads to reduction of size for these blood cells.

This image shows the Anisocytosis cells of unequal size that are found in the blood stream Poikilocytosis photo

Picture 3: This image shows the Anisocytosis cells of unequal size that are found in the blood stream
Image Source: 4.bp.blogspot.com

This image depicts the health condition Anisocytosis where red blood cells are not equal in size Poikilocytosis images

Image 4: This image depicts the health condition Anisocytosis where red blood cells are not equal in size
Photo Source: www.drugskey.com

Causes of Anisocytosis

There can be various causes that lead people to this rare disease. They are
Deficiency of Iron: Iron helps to carry and store oxygen in your blood. Lack of sufficient iron in your blood can lead to reduction of size of red blood cells which lead to Anisocytosis.

  • Deficiency of Vitamin A: Vitamin A helps to strengthen the immune system of the body. Lack of Vitamin A can also cause red blood cells to shrink which leads to Anisocytosis.
  • Deficiency of Vitamin B12: Vitamin B12 is vital to create new red blood cells. Lack of Vitamin B12 leads to pernicious anemia which in turn results in Anisocytosis.
  • Myelodysplastic Syndrome: This is a rare disease which creates abnormal bone marrow and blood which can lead to Anisocytosis.
  • Diamond-Blackfan Anemia: In this medical condition the bone marrow becomes unable to produce enough red blood cells. This can also cause Anisocytosis.

However in other cases, health issues such as protein deficiency, chronic liver disease and hemoglobin H disease can also lead to this disease.

Types of Anisocytosis

There can be three types of this disease. They are as follows

  • Macrocytosis: In this case, red blood cells are larger than usual. It is recorded that it affects around three percent of the total american population.
  • Normocytic anemia: This type occurs when a person has normal-sized red blood cells, but there is a low amount of the cells.
  • Microcytosis: In this case the red blood cells are smaller than usual.

Symptoms of Anisocytosis

As a result of unequal red blood cells, not enough nutrition reaches all the tissues of our body. As a result, the patient faces tiredness, shortage of breath, dizziness and chest pain. Other symptoms like pale skin, cold feet and headache are also common.

Diagnosis and treatment

The best way to diagnose this disease is by blood smear. Blood samples are examined under microscope to analyze their structure. There are many things that are taken into account like number of red cells, cell volume, average amount of hemoglobin in each red blood cell and width of red cells. The results indicate the type of Anisocytosis the person has.

As the primary reason of Anisocytosis is anemia, best form of treatment is to eat iron rich food like brown rice, pulse, beans, meat, fish and eggs. However extra supplements can be also taken to treat the disease.


  1. http://www.actforlibraries.org/poikilocytosis/
  2. https://www.healthline.com/health/poikilocytosis#types5
  3. https://www.drugskey.com/anisocytosis-definition/
  4. https://www.healthline.com/health/anisocytosis#symptoms2
  5. https://www.medicalnewstoday.com/articles/319852.php

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