Clinical haematology · UKMLA & AKT
Platelet abnormalities on blood film
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Howell-Jolly bodies and siderocytes - nuclear remnants and iron-containing granules normally removed by spleen; presence = hyposplenism
- Causes of hyposplenism: coeliac disease (commonest medical cause in UK), post-splenectomy, sickle cell disease (autosplenectomy), splenic irradiation
- Platelet clumping - grape-like clusters at film periphery/feathered edge; causes spuriously low platelet count (pseudo-thrombocytopenia)
- Giant platelets - approaching/exceeding red cell size; seen in ITP, Bernard-Soulier syndrome, myeloproliferative disorders
- Thrombocytopenia + schistocytes - jagged helmet-shaped red cell fragments + low platelets = MAHA until proven otherwise (TTP, HUS, DIC, HELLP)
- Hypogranular platelets - pale, poorly granulated; suggests myelodysplastic syndrome or grey platelet syndrome
Howell-Jolly bodies + siderocytes on blood film = hyposplenism. In the context of coeliac disease, malabsorption causes hyposplenism - a classic exam pairing.
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