Elliptocytosis

Elliptocytosis or idiopathic idiocytoplasmic hypertensive erythroblastic anemia is a disorder of hematopoiesis due to an unknown cause. The disease belongs to the group of myelodysplasias of the red line of hematopoiesis. It is characterized by inhibition of the early stages of hematopoietic production - myeloblastic and promyelocytic.

Elliptocytes are found in the peripheral blood of patients in the form of single elements. With a long course of the disease, a macrocytolytic (macroerythrocytic) picture develops, polymorphonuclear cells displace hemoglobin-containing elements from peripheral blood smears. Diagnosis is carried out by microscopic examination of peripheral venous and/or capillary blood and sternal puncture. Treatment of the disease requires a clear identification of the causes of the pathology and the appointment of etiopathogenetic drug therapy.

To detect pathology, the following diagnostic methods are used: * myelogram; * count the number of red blood cells with an average diameter ≥ 6 μm with a normal or increased nucleus/cytoplasm ratio; * increase the number of small cell pseudoerythrocytes, normocytic splenocytes and reticulocytes; * take into account the presence or absence of degenerative changes in the nucleus and hypertrophy of the erythroid germ. With long-term macrocytic anemia, specific hematological variability is observed with the replacement of monomorphic erythrocytes by a wide range of heteromorphically and polymorphically colored bodies. In a blood smear, there are two types of abnormal forms of red blood cells:

- macrocytes (>8 µm); distinguished by a basophilic or basophilic-granular oxyphilic grain in the center of the cytoplasm; have an increased nuclear size with small nucleoli, located in isolation or among the normal cellular background. - microforms of medium size (7–6 microns); have basophilic or oxyphilic cytoplasmic substance; have tiny nucleoli located under the blanching membrane and inside it; often form conglomerates, but are found among mature normocellular erythrocytes. The main role in diagnosis is given to indirect methods: the average diameter of a red blood cell, the percentage of hemoglobin saturation, and the average hemoglobin content in one red blood cell are determined. The study of the picture of peripheral and venoarterial blood is complicated by the visual similarity of morphological differences between the erythrocytes of the two groups.