Elliptocytosis

 

Created 21 December 2019.
Updated 13 January 2021 (incorporated into atlas from original blog entry)

Updated 23 September 2022 (incorporated new case and more references)
Updated 30 April 2025 (incorporated new case and more references)

Updated 6 January 2026 (Updated to new format)

 

Elliptocytes can occur in many conditions (e.g. iron deficiency, leukemias, megaloblastic anemias, myeloproliferative diseases, myelodysplastic syndromes) but do not reach the proportions observed in patients with hereditary elliptocytosis…

 

 

 

 

 

 

Look at this !!!  A ten-year-old child turned up at A&E four days before Christmas with a fever. The blood count was rather unremarkable, but my colleague made a blood film purely because the patient was a child. Rather unscientific perhaps, but I must admit that I tend to err on the side of caution.

But look at those red cells…

 

 

 

Another complete chance finding

 

 

And here’s another that turned up on a Friday in September

A complete chance finding in a teenaged child with an unexplained (and utterly unconnected) neutropenia.

 

 

Here’s an interesting one – a TATT from the GP…

 

M6795349            NAME                03.05.73  F

Specimen H,25.7719927.Y      Clin dets

Collected 30.04.25 09:24     A.Diag

----------------------------------------------------------------------------

Hb         - 64           |Eosin        0.10

WBC          5.33         |Baso         0.02

Plts         359          |MPV          11.9 

Hct        - 0.233        |PCT          0.43

RBC        - 3.09         |NRBC         0.01

MCV        - 75.4         |RETP         4.4

MCH        - 20.7         |RETA       + 135.00

MCHC       - 275          |IRF          26.3

Neuts        3.67         |

Lymphs       1.10         |

Monos        0.44 

 

 

Usually people with H.E. have “normal” MCV, but this one was microcytic… don’t forget that despite having H.E., people can still get iron deficient.

If anything they are probably more likely to get iron deficient than the average person as they’ve got an admittedly compensated haemolytic process going on.

 

 

I’ve seen elliptocytosis several times before. The case which I remember most (the first one I found myself!) was an eighty-six year old chap with a chest infection.
Just like in these cases the elliptocytosis was seen as a chance finding and is benign.

 

Some More Expert Opinion…

 

My original blog entry on the matter

 

Wikipedia’s say on the issue

 

A Dissertation from the NIH

 

https://path.upmc.edu/cases/case623/dx.html

 

https://www.ijhsr.org/IJHSR_Vol.5_Issue.9_Sep2015/93.pdf

 

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2141.1999.01130.x

 

https://imagebank.hematology.org/image/65014/hereditary-elliptocytosis

 

https://rarediseases.info.nih.gov/diseases/6621/hereditary-elliptocytosis