Diagnosis: Sickle cell disease
• The cell shown in the photomicrograph is a classical sickle cell seen when hemoglobin S precipitates in deoxygenated states resulting in deformation of the erythrocytes.
• Sickled cells are less efficient for oxygenation and more prone to lysis and obstruction of small capillaries resulting in the ischemic complications of sickle cell crisis.
• Congenital deficiency of cytoskeleton proteins most commonly results in spherocytosis (hereditary spherocytosis) or elliptocytosis (hereditary elliptocytosis), not sickle cells (A).
• Fragmentation of cells by mechanical shearing (microangiopathic hemolytic anemia) results in schistocytes (C).
• Crenated erythrocytes (also known as echinocytes or burr cells), which can be seen in uremia, have changed from a disc shape to spheres covered with short, sharply pointed projections. They are usually artifactual but may be seen in conditions such as uremia (E).
• Sickle cells are not an artifact of smearing (B).
