#MT2B

Anemia is a group of conditions that occur when red blood cells survive less than 120 days in circulation, causing low hemoglobin levels in the blood. Pictured above is an iron deficiency anemia in a young female patient due to nutritional deficiency. Iron deficiency is more common in females due to heavy menstrual periods and increased needs during pregnancy. Another common cause in males and females is gastrointestinal bleeding. Nutritional deficiency is an uncommon cause in the modern western world due to many of our foods and supplements being fortified with iron, and the fact that it can take many years to deplete the body’s iron stores.

Iron deficiency anemia is classified as a microcytic, hypochromic anemia. This means that the cells are smaller and less saturated with hemoglobin than they ought to be. I can identify a micro/hypo anemia under the microscope by comparing the red cells to the nucleus of an average sized lymphocyte. If the red cells are normocytic, they will be about the same size. Sadly there are no lymphocytes present in this field but judging by the size of the PMN and the large central pallor of these red cells, they are clearly micro/hypo.

Eosinophil (seen under 100x oil immersion): a type of specialized immune cell that promotes inflammation and helps to fight infection. Eosinophils normally make up about 1-3% of leukocytes, are 12-17 microns in diameter, and have a bilobed nuclei. They feature trademark reddish-orange granules by which they can be easily identified. These granules may be marvelous to look at once prepared but before being stained with Romanowsky they do not have any color. They contain digestive enzymes that are not only toxic to parasitic intruders but to host tissues as well.

Eosinophilia, or an increase in eosinophils, may be caused by parasitic infection, hay fever, asthma, eczema, and many more. The immune system is pretty amazing due to the fact that it can send out different types of white blood cells based on what the body needs.

Howell-Jolly body (100x): a small, round erythrocytic inclusion composed of remnant DNA. We often see these in the peripheral blood of our patients who are asplenic, or in this case, a sickle cell patient in crisis.