Clinical haematology · UKMLA & AKT
Red cell 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
- The spleen normally pits inclusions and removes abnormal RBCs. Loss of splenic function produces a characteristic film pattern.
- Film findings: Howell-Jolly bodies, target cells, acanthocytes, Pappenheimer bodies, mild thrombocytosis
- Causes: splenectomy, sickle cell disease (autosplenectomy), coeliac disease (~1/3 of patients), Crohn's disease, haematological malignancy (lymphoma, amyloidosis), splenic irradiation
Coeliac disease (positive anti-TTG IgA + iron deficiency) is a classic cause of acquired hyposplenism - expect target cells AND Howell-Jolly bodies together on the film.
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