Diagnosis: Red cell morphology
• Schistocytes are fragmented red blood cells, often showing a half-disk shape with two or three pointed extremities; they may be a small, irregular fragment.
• Schistocytes can be found in the microangiopathic hemolytic anemias, thrombotic thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (HUS).
• Because TTP is lethal unless treated with plasmapheresis or plasma infusion, the correct reporting of schistocytes can be of utmost clinical importance.
• Schistocytes can also be seen in patients with disseminated intravascular coagulation.
• Other conditions in which schistocytes can be seen include severe burns, march hemoglobinuria, and heart valve hemolysis.
