Clinical haematology · UKMLA & AKT

Red cell abnormalities on blood film

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise red cell abnormalities on blood film — the full SA Note notes add investigations, management, complications and 10 practice questions.

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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