PBS for Schistocytes

Anemia

Report in 72Hrs

At Home

No Fasting Required

Details

Indicators of microangiopathic hemolytic anemia (MAHA) and related serious conditions.

₹149₹275

46% OFF

PBS for Schistocytes - Comprehensive Medical Test Guide

Why is it done?
- PBS (Peripheral Blood Smear) for Schistocytes detects and identifies fragmented red blood cells (RBCs) called schistocytes or helmet cells that result from mechanical damage to erythrocytes as they circulate through the bloodstream
- Diagnose microangiopathic hemolytic anemia (MAHA) and conditions causing mechanical destruction of red blood cells within blood vessels
- Evaluate patients presenting with hemolytic anemia, thrombocytopenia, and renal dysfunction (thrombotic microangiopathies)
- Monitor patients with disseminated intravascular coagulation (DIC), hemolytic uremic syndrome (HUS), or thrombotic thrombocytopenic purpura (TTP)
- Assess for mechanical hemolysis from prosthetic heart valves, severe burns, or malignant hypertension
- Typically performed as part of routine complete blood count (CBC) follow-up when hemolytic anemia is suspected or confirmed
Normal Range
- Schistocytes Present: Normally absent or <1% of total red blood cells Absence indicates normal RBC morphology
- Units of Measurement: Reported as percentage (%) of RBCs observed on smear Qualitative assessment (present/absent) or semi-quantitative (rare, few, moderate, numerous)
- Normal vs Abnormal: Normal: No schistocytes identified or <1% of RBC population Abnormal (Positive): Presence of schistocytes (>2-3% or reported as present)
- Schistocyte Morphology: Helmet cells, triangle cells, or fragmented RBC forms Appearing as small, dense, irregularly shaped RBC fragments
Interpretation
- No Schistocytes Present: Indicates normal RBC morphology and likely absence of mechanical hemolysis Rules out microangiopathic hemolytic anemia Normal finding in healthy individuals
- Rare Schistocytes (1-2%): Borderline finding that may be clinically insignificant Can be seen in early stages of thrombotic microangiopathy Requires correlation with clinical presentation and other laboratory findings Consider repeat testing if clinical suspicion remains high
- Few to Moderate Schistocytes (2-10%): Indicates mechanical hemolysis occurring Suggests presence of thrombotic microangiopathy Consistent with MAHA associated with thrombotic conditions Warrants further investigation and clinical correlation
- Numerous Schistocytes (>10%): Indicates severe microangiopathic hemolytic anemia Suggests active mechanical destruction of RBCs May be associated with acute thrombotic crisis (TTP/HUS) Often accompanied by hemolysis markers and thrombocytopenia Requires immediate clinical intervention
- Factors Affecting Results: Specimen preparation and staining technique quality Blood smear location (center vs edges) may affect cell representation Timing of sample collection relative to acute hemolytic episode Observer experience in identifying schistocyte morphology Presence of other RBC abnormalities affecting identification
- Clinical Significance Patterns: Schistocytes + low haptoglobin + elevated LDH = strong evidence of hemolysis Schistocytes + thrombocytopenia + renal dysfunction = suggestive of TTP/HUS Schistocytes + prolonged PT/INR = concerning for DIC Schistocytes in patient with mechanical valve = expected finding
Associated Organs
- Primary Organ Systems Involved: Hematologic system (bone marrow, blood vessels, red blood cells) Cardiovascular system (mechanical stress on RBCs, blood flow dynamics) Renal system (often affected in thrombotic microangiopathies) Coagulation system (interaction with platelet aggregation)
- Conditions Associated with Schistocytes: Thrombotic Thrombocytopenic Purpura (TTP) - ADAMTS13 deficiency Hemolytic Uremic Syndrome (HUS) - Shiga toxin-producing organisms Disseminated Intravascular Coagulation (DIC) Malignant hypertension causing endothelial damage Prosthetic heart valve-related hemolysis Severe burn injuries Scleroderma renal crisis Preeclampsia/HELLP syndrome Antiphospholipid syndrome Infection (meningococcemia, pneumonia, viral infections)
- Complications of Abnormal Results: Acute hemolytic anemia with risk of cardiovascular instability Acute kidney injury from hemoglobin precipitation in renal tubules Thrombotic events from platelet aggregation Neurological complications if central nervous system microthrombi occur Potential end-organ damage from microvascular thrombosis Bleeding complications if severe thrombocytopenia develops Hyperkalemia from hemolysis in severe cases
- Diagnostic Significance: Key finding in diagnosis of thrombotic microangiopathies Essential component of hemolytic anemia workup Helps differentiate mechanical vs immunologic hemolysis Guides clinical decision-making for plasma exchange therapy Important for monitoring disease progression and treatment response
Follow-up Tests
- Hemolysis Markers: Serum LDH (elevated in active hemolysis) Serum haptoglobin (decreased with ongoing hemolysis) Serum bilirubin (indirect - elevated from hemoglobin breakdown) Reticulocyte count (elevated indicating compensatory RBC production)
- Coagulation and Platelet Studies: Platelet count assessment Prothrombin time (PT/INR) - for DIC screening Activated partial thromboplastin time (aPTT) Fibrinogen level D-dimer - elevated in thrombotic conditions
- Specific Thrombotic Microangiopathy Testing: ADAMTS13 activity (von Willebrand factor-cleaving protease) ADAMTS13 inhibitor testing Complement analysis if secondary TMA suspected Shiga toxin detection or STEC serology if HUS suspected
- Renal Function Assessment: Serum creatinine and BUN Estimated glomerular filtration rate (eGFR) Urinalysis (proteinuria, hemoglobinuria, hematuria)
- Additional Diagnostic Testing: Blood cultures if infection suspected Chest X-ray for respiratory symptoms Neurological assessment if altered mental status present Imaging studies as clinically indicated
- Monitoring Frequency: Daily or every other day during acute episodes Weekly during active treatment phase Monthly once in remission Every 3-6 months for long-term monitoring of chronic conditions More frequent testing if clinical deterioration occurs
- Related Complementary Tests: Coombs test (direct antiglobulin test) - to rule out immune hemolysis Flow cytometry - for specific cell line analysis if needed Bone marrow biopsy - if bone marrow failure suspected Repeat peripheral blood smear - for trend assessment
Fasting Required?
- Fasting Requirement: NO - Fasting is NOT required for PBS for Schistocytes
- Patient Preparation: Patient may eat and drink normally before test No special preparation required Test can be performed at any time of day No need to avoid medications
- Specimen Collection Requirements: Venipuncture (blood draw) from antecubital vein Specimen collected in EDTA (lavender top) tube Gentle handling to prevent artificial RBC fragmentation Timely processing (typically within 2-4 hours of collection) Transport at room temperature to preserve RBC morphology
- Medications: No medications need to be stopped before test Continue all regular medications as prescribed Inform laboratory of medications patient is currently taking Some medications may affect results (reported for reference only)
- Special Instructions: Patient should be well-hydrated for ease of venipuncture Inform phlebotomist if patient has bleeding disorders or is on anticoagulation Sit quietly for 5 minutes before blood draw if possible Avoid excessive tourniquet application to prevent hemolysis Inform laboratory if patient has thrombophilia or platelet disorders
- Timing Considerations: Can be performed any time of day Optimal for acute conditions - collect during suspected hemolytic episode For trending, collect at consistent times for better comparison Emergency specimens prioritized in acute presentations

How our test process works!