Red blood cell abnormalities in cardiac valvular disease

Evaluation of fragmented red cell (FRC) counting using Sysmex XE‐5000 – Does hypochromia play a role?

“…It is usually accompanied by haemolytic uraemic syndrome (HUS), disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), preeclampsia, malignant hypertension, acute glomerulonephritis, Wegener granulomatosis and systemic lupus erythematosus . Macroangiopathic haemolytic anaemia caused by mechanical intravascular haemolysis within large vessels is most commonly associated with abnormal turbulent blood flow over the surface of a diseased heart valve, defectuous prosthetic valves, endocarditis, aortic aneurysm or a patch used to close an intracardiac defect .…”

Hemolytic Anemia in a Patient with Subacute Bacterial Endocarditis Due to <i>Streptococcus sanguis</i>

“…Shear stress is a physical force to which red blood cells in flowing blood are exposed, and the application of 250 Pa or greater to normal red blood cells in vitro results in hemolysis [8]. Fragmentation hemolysis has been well documented in patients with valvular heart disease [9], In our patient, fragmentation of red blood cells was not apparent, and the anemia improved in spite of the unchanged vegetation of the mitral valve and the severe regurgitation. Thus, it is unlikely that a traumatic mechanism was the major cause of hemolysis in our case.…”

2021 update of the 2012 ICSH Recommendations for identification, diagnostic value, and quantitation of schistocytes: Impact and revisions

“…A recent study has described how increased schistocyte percentages in COVID‐19 patients are associated with high levels of von Willebrand factor (VWF) and lactate dehydrogenase (LDH), decreased platelet counts, and low ADAMTS13 activity 26 . Schistocytes may also be detected in both inherited 27,28 and acquired 29 dyserythropoietic and hemolytic disorders, usually presenting in the context of anisopoikilocytosis and the presence of mechanical 30 or thermal 31 RBC injuries. High schistocyte counts have also been found after snake bite venom‐induced consumption coagulopathy, only occasionally resulting in TMA associated with acute kidney injury 32,33 …”