Anisocytosis the concept of the norm in the analysis of blood species what it says

The meaning of the concept of anisocytosis and what is it? Normal red blood cells that make up the blood are called normocytes. In a healthy person, the size of these cells corresponds to a value of 7-7,5 microns. The diameter of microcytes is 6,9 microns. The size of megalocytes is 12 microns, of macrocytes is 8 microns. In percentage terms, the number of normacytes occupies about 70% of the blood volume, respectively, the number of macrocytes and microcytes should be up to 15%. Violation of this ratio indicates the development of anisocytosis.

Symptoms of the disease are similar in nature to anemia, heart failure. The patient feels weakness, decreased performance, quickly gets tired. Often there is a violation of the heartbeat, shortness of breath and other symptoms.

Important! Often anisocytosis is asymptomatic, it is detected during a blood test during routine examinations.

Anisocytosis of platelets and leukocytes does not apply to independent diseases. The diameter, color and shape of the blood cells changes against the background of various disorders in humans.

  • errors in nutrition. A slight violation of the level of blood cells can indicate malnutrition or insufficient intake of certain components in the body. Of course, this factor cannot provoke a strong deviation from the norm, but it cannot be ignored;
  • lack of iron, vitamins A and B12. These elements are necessary for the normal formation of red blood cells. Vitamin A ensures the maintenance of a normal cell diameter. If iron and vitamin B deficiency occurs12, the percentage of blood elements is violated, which can cause anisocytosis;
  • blood transfusion. Often, after a blood transfusion from a donor that has a deviation from the norm in the form of anisocytosis, this condition will also develop in a person who has taken blood. This is explained by the inability of the immune system to quickly normalize these indicators. If a person is healthy, after a while, anisocytosis will disappear on his own;
  • oncology. Bone marrow neoplasms always entail a violation of the blood;
  • diseases of the thyro >

A common cause of anisocytosis is a lack of vitamins and iron deficiency in the blood

With a prolonged course of infectious diseases, severe intoxication of the body, transient compensatory anisocytosis is noted. This condition is characterized by a change in the structure of the cells of lymphocytes and leukocytes.

Macrocytosis is more often found in anemia, leukemia, liver and pancreas diseases. Often in combination with this, the patient is diagnosed with hypochromia – a decrease in hemoglobin production.

Anisocytosis is not an independent disease, the condition is characterized by a violation of the blood composition under the influence of a particular pathology (for example, anemia, oncology, liver disease). Symptoms of this condition can be very diverse, depending on in which organ pathological changes occur.

Common signs of anisocytosis include asthenia. The concept implies the development of a person’s weakness, fatigue, irritability. When performing light physical work, the patient notes shortness of breath, loss of strength. There are violations from the psychological state. Often, sleep is disturbed, mood changes occur, a person becomes aggressive, or, conversely, apathy develops, reluctance to communicate with other people.

Many patients are diagnosed with heart rhythm disturbance. As a result, pallor or redness of the skin, dizziness, flickering of flies in front of the eyes may occur.

In general, anisocytosis is characterized by signs of heart failure, but when examining the heart, no abnormalities in the work of the organ are noted, because the symptoms occur due to a violation of the percentage of blood cells, which can cause difficulties in diagnosis.

How to detect anisocytosis in a general blood test? In humans, it contains platelets, which are responsible for its coagulation, white blood cells. They are called white bodies, which perform their functions in the fight against foreign particles and infections. The erythrocytes play a very important role for life, which transport oxygen and nutrients to the cells and are involved in the transfer of carbon dioxide. The structure and shape of red blood cells is not the same, that is, they are represented by different sizes:

  • Normocytes include cells ranging in size from seven to nine micrometers.
  • Microcytes or microerythrocytes are cells up to seven micrometers in size.
  • Macrocytes can include cells as small as eight micrometers.
  • Megalocytes are cells from a size of twelve micrometers.

Provided that all indicators of red blood cells in the blood are normal and the person is completely healthy, the number of normocytes does not exceed seventy percent of the total number of red blood cells, and macrocytes and microcytes account for up to fifteen percent. If during the analysis it becomes known that some indicator is higher than normal or, conversely, lower than expected, this indicates any disturbances in the body.

From the definition it follows that anisocytosis in a general blood test is a modification of the size of red blood cells and platelets. In the case when this violation is poorly expressed, a number of additional studies should be conducted to discard the likelihood of serious diseases of the body. Hemoglobin decreases in red blood cells and this leads to anemia. Despite this, it is necessary to carefully check the state of the blood in order to exclude more serious deviations.

Anisocytosis is a condition that in most cases is a sign of anemia. Symptoms are similar to each other. Severe signs of this condition resemble a manifestation of heart failure. If you find the symptoms described below, consult your doctor and have a complete blood count done:

  • fatigue;
  • decreased performance;
  • decreased attention span;
  • lack of ability to play sports;
  • powerlessness and breakdown;
  • shortness of breath with exertion or for no apparent reason, appearing periodically;
  • palpitations without any load;
  • increased tremors of the heart muscle;
  • pale skin;
  • pale color of the nail plates;
  • pallor of eyeballs;
  • headache;
  • noise in ears;
  • disturbances in normal appetite and sleep;
  • decreased sex drive;
  • violation of the sensitivity of the skin.

If these symptoms appear, consult a doctor.

In healthy people, the number of normal red blood cells in a blood test is at least 70%, macrocytes and microcytes – no more than 15%. For adult men and women, this indicator should be in the range from 11,5 to 14,5%.

In children under six months of age, the RDW index should be between 14,9 and 18,7%. Starting from six months, this parameter in value approaches the norm of an adult – 11,6-14,8%.

If the number of small or large red blood cells is more than normal, they say that RDW is increased. Deviations from the norm of this indicator, as a rule, indicate pathological processes in the body.

Anisocytosis is an early sign of anemia, the severity of which is determined by its degree. The main reasons for increasing RDW in both adults and children are as follows:

  • Iron-deficiency anemia.
  • Hemolytic anemia.
  • Megaloblastic anemia (vitamin B deficiency12 and folic acid).
  • Chronic liver disease.
  • Liver metastases.
  • Blood transfusion.
  • Myelodysplastic syndrome.
  • Alcohol addiction.

In addition, RDW can be increased in Alzheimer’s disease, hemoglobinopathy, lead poisoning, microspherocytosis, bone marrow metaplasia, and cardiovascular diseases.

During the treatment of anemia, the iron deficiency index of the anisodisode rises. This is due to the appearance in the blood of a large number of young red blood cells, which differ in diameter from mature ones. With effective treatment, RWD is normalized, but after the rest of the indices.

Changing the size of red blood cells in diameter is considered a diagnostic marker that informs about the risk of developing coronary heart disease.

RDW is practically never low. Upon receipt of such a result, most likely, you should retake the analysis. If the indicator is lowered slightly and there are no other changes in blood tests, this result should be considered a variant of the norm. Reduced RDW has no diagnostic value.

With some pathologies, RDW does not change, the indicator remains normal. These include the following conditions:

  • anemia accompanying chronic diseases;
  • β-thalassemia;
  • spherocytosis;
  • acute aplastic and hemorrhagic anemia;
  • sickle cell anemia.

The circulatory system is the foundation of the human body. One of the criteria for assessing the state of health determines the state of the blood by taking part of the serum components. As a general rule, only with a quantitative enzymatic composition can pathologies and deviations from the norm be distinguished.

A large role is given to the size of the elements. In a general analysis, anisocytosis is visible – a modification of the size of blood cells, which can turn into anemia. This is one of the diseases that, when neglected, can turn into serious problems.

In every element of the blood, regardless of whether red blood cells, white blood cells or platelets are, there are clear dimensions. When viewing the appearance of the parts together, the type of disease is determined.

In medical practice, 30% (15 15) of particles having a non-standard size are considered an acceptable norm: almost half is larger, the second half is smaller. With an increase in heterogeneous elements, the body develops pathological processes.

The severity is determined depending on the imbalances of normal cells and enlarged cells.

Modified cells do not indicate a diagnosis. The specialist is guided in further actions. If a slight deviation from the norm is detected, the doctor will prescribe an additional examination to exclude possible violations.

A different type of anisocytosis manifests itself in newborns, infants, as well as in preschoolers and schoolchildren. Microcytes in high levels are observed after infectious diseases.

Platelet Anisocytosis

The platelets in our body are responsible for blood coagulation.

Platelet Anisocytosis: What Is It? By analogy with the above information about red blood cells, platelet anisocytosis is an abnormal change in platelet size that goes beyond the normal range.

Platelet size changes with the onset of myeloproliferative processes. The change in particle diameter can also be associated with their deposition, association and with a lack of biologically active substances.

If the PDW indicator is below normal, this may be the basis for testing for the following diseases:

  • leukemia;
  • anemia;
  • radiation sickness;
  • viral diseases;
  • Niman peak disease
  • myelodysplastic syndrome;
  • another.

The treatment of platelet anisocytosis includes, first of all, getting rid of the underlying disease causing the anomaly.

In fact, doctors in determining the state of human health rely not only on the quantitative composition of the blood. After a general analysis, an idea appears about the changes occurring in the body, in terms of size and type of red blood cells, platelets. Anisocytosis is a rather unusual disorder that occurs in adults and children and can lead to pathologies associated with changes in the size of blood cells, which may indicate the development of diseases and makes it necessary to conduct additional examinations and treatment.

Anisocytosis is a pathological change in the size of red blood cells and platelets that occurs against various human diseases. More often in medical practice, anisocytosis of a mixed type is diagnosed.

Blood is the internal environment of the body, performs an important function, providing all organs and systems with oxygen and nutrients. A change in the shape and size of the cells of this substance more often indicates the development of serious diseases, but additional medical research is required to clarify the diagnosis.

The capabilities of modern hematological automatic systems, along with the determination of various blood parameters (the number of red and white cells, the level of hemoglobin and hematocrit, erythrocyte indices and leukocyte formula), allow you to count blood platelets – platelets (which, when processing a general blood test manually require a separate stain) as well as platelet indices and platelet anisocytosis index – PDW.

examples of platelet histograms: normal, thrombocytopenia, hypertrombocytosis (presence of macro-platelets)

In the automatic analyzer, one channel with red blood cells is used for platelet counting, therefore these devices are equipped with a special system of electronic discriminators that differentiate:

  1. Macro thrombocytes;
  2. Red blood cells;
  3. Schizocytes (fragments of red blood cells);
  4. Cell debris (fragments of the cytoplasm of white cells – white blood cells).

PDW is an indicator of platelet anisocytosis, the norm of which is from 14 to 20%, together with other platelet indices (PCT, P-LCP) has no special diagnostic value. The greatest amount of information in such cases can be expected from a histogram of platelet distribution.

Changes in the platelet anisocytosis index upward are characteristic of myeloproliferative processes, downwardly, for individual forms of leukemia, aplastic anemia, DIC, severe liver damage and some other conditions.

Anisocytosis: description and causes

Not always a change in the size and shape of the blood components indicates pathological processes in the body.

The norm is considered if the deviation does not exceed 30% of the total number of red blood cells and white blood cells, while their percentage must be taken into account in relation to each other – it should be approximately the same.

In the vast majority of cases, anisocytosis occurs simultaneously with poikilocytosis – a condition in which the structure of red blood cells deforms and their work is disrupted.

The standard size of red blood cells (blood cells containing hemoglobin and providing gas exchange in the body) can range from 7 to 9 micrometers. If these numbers are less than or greater than the normal indicator, anisocytosis is diagnosed in a person, which can occur in several forms, which are classified by the size of the prevailing red blood cells.

Type of anisocytosis The size of the deformed cells that make up the erythrocyte mass (in micrometers).

Microcytosis ≤ 6,9
Macrocytosis 8 – 12
Megalocytosis 12 ≥
Combined Anisocytosis In the blood, all three varieties of altered red blood cells can be determined in different percentages.

Normal red blood cells under an electron microscope

When it comes to anisocytosis, in most cases we mean the excess of the number of red blood cells of a non-standard size by more than 30% of the total number of red blood cells, but sometimes the changes also affect small red spherical plates – platelets. Platelets are responsible for blood coagulation, and a change in their size is almost always caused by pathological processes in the body, which may have a sluggish course, and are detected by chance in the study of a general blood test.

If the patient is diagnosed with platelet anisocytosis, the doctor will definitely prescribe an additional examination to exclude diseases of the hematopoietic system (including oncological processes), severe viral pathologies and diseases accompanied by latent forms of inflammation. When diagnosing, the doctor also necessarily takes into account the degree of pathology, which depends on how much the deviations exceed the permissible norm.

Degree of deviation Minimum volume of modified blood components (as a percentage of the total mass) Maximum volume of modified blood components (as a percentage) As indicated in the transcript of the analysis?

The first (minor deviations) 15 25
The second (the change in the size of blood cells is not much higher than the permissible norm) 25 50
Third (anisocytosis exceeds the norm by more than 50%) 50 75
Fourth (pronounced, requires immediate examination and correction / treatment) 75 100
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You should know it! In deciphering the results of a general blood test, erythrocyte anisocytosis and platelet anisocytosis are designated as RDW and PDW, respectively.

Both quite harmless factors that can be easily corrected (for example, a monotonous, unbalanced diet) and serious diseases, including malignant blood damage, can lead to the development of pathology.

If a person eats improperly, abuses semi-finished products, canned goods, products with a large number of chemical additives (flavorings, dyes, preservatives), red blood cells and platelets can slightly change their size, but serious deviations are usually not observed.

Improper nutrition can lead to blood diseases.

Various forms of anemia, especially iron deficiency anemia, in which there is a decrease in the level of hemoglobin, a complex iron-containing protein, the main component of an erythrocyte cell, can negatively affect the structure and appearance of blood components.

Lack of carotene, retinol, vitamins B12 and B6 can also cause modification of the formed components of the blood.

Pathological causes of anisocytosis include:

  • leukemia – a type of leukemia, a malignant lesion of the hematopoietic system; Leukemia
  • anemia (anemia) – a disease in which the amount of hemoglobin and the number of red blood cells per unit of blood is reduced; Anemia (anemia)
  • Nimann-Peak disease – a metabolic reaction disorder in which lipids accumulate in tissues and cells of internal organs (spleen, liver, lung tissue, etc.); Nimann-Peak disease
  • pathological processes in myeloid tissue (spinal cord cells);
  • malignant tumors of the bone marrow, blood-forming system and other organs. Cancer of the bone marrow

An increase in anisocytosis can be caused by the systematic exposure to radiation. Such a situation can be observed in cancer patients undergoing radiation therapy, and among workers in machine and shipbuilding enterprises whose activities are related to the manufacture of parts for submarines, military equipment and missile equipment.

Note! In some cases, moderate anisocytosis may be present in viral infections, for example, infectious mononucleosis, flu, rotavirus infection, viral hepatitis and other diseases caused by various groups of viruses.

Blood is a liquid tissue that circulates throughout the body, the main function of which is the transport of substances. The blood contains plasma and formed elements – platelets, red blood cells and white blood cells.

Red blood cells are blood cells that contain protein structures (hemoglobin) that perform the function of binding oxygen and carbon dioxide. These cells give the blood a red color due to the content of iron compounds in them. Contained oxygen provides nutrition to body tissues and is the main component of metabolic processes occurring in it.

The remaining red blood cells, representing 15% of the total number, are either smaller (microcytes) or larger (macro- and megalocytes). Thus, the answer to what anisocytosis is will be a high level of red blood cells of an abnormal size.

The very structure of the term (an – isocytosis) translates as a negation of isocytosis, that is, the same cell sizes).

Red blood cell anisocytosis is physiologically normal for newborns in the first days of life. In other cases, a high rate of red blood cell anisocytosis may be a sign of any pathological condition.

These include, for example, a shortage of “building materials” for red blood cells – iron, vitamins A and B.

In addition, liver diseases, oncological diseases and anemia of various origins can increase the proportion of red blood cells of anomalous size in the blood.

Red blood cell anisocytosis is indicated by the RDW index, i.e. red blood cell volume distribution index. The index can be indicated in various ways, for example, in femtoliters (fL), its norm ranges from 10 to 20 units, in percent – from 11,5% to 14,5%. The most common and simple designation scheme is the “plus system”, which is used by many laboratory assistants to designate certain threshold values ​​of anisocytosis.

() – a slight anisocytosis of erythrocytes was detected in the blood test, the proportion of cells of an abnormal size does not exceed a quarter of the total number of red blood cells;

() – RDW index is moderately increased, i.e. the number of different-sized cells is about half;

() – this indicator indicates a high level of anisocytosis, in which almost ¾ of all red blood cells go beyond the normal cell size;

() – RDW index is not just above normal, but normal size red blood cells are practically not present in the blood.

Thus, the reasons that the RDW index is increased in blood can be of a different nature, and the intensity of violation of uniformity of the size of blood cells can be calculated in different units.

Despite the fact that most often a qualitative state of red blood cells is determined in a blood test, there is another type of anisocytosis – platelet anisocytosis. Its definition, designation and degree of intensity are correlated with those of red blood cells in a percentage ratio. The only difference is that the normal proportion of the normal platelet fraction among these blood cells is from 14% to 18%. In addition, the anisocytosis index for platelets is indicated not as RDW, but as PDW.

Platelets are blood cells that are involved in thrombosis, i.e. stop bleeding and promote normal blood coagulation. For the normal functioning of the body, the presence of a sufficient number of platelets and their normal condition is important, otherwise any open wound or other trauma can lead to severe hemorrhage and blood loss.

Anisocytosis can be increased relative to the normal level of distribution of platelet diameter in myeloplastic processes, leukemia, aplastic anemia, liver failure and venom of other pathological conditions.

In addition to the separation by type of blood cell, there is a classification of anisocytosis according to the qualitative characteristic of changes in the size of blood cells. For example, microcytosis is a condition in which the number of small blood cells is exceeded, and macrocytosis is large.

Mixed is a type of anisocytosis in which an excess of the number of blood cells of an abnormal size occurs due to both increased and decreased red blood cells and platelets. This condition occurs with some types of anemia, however, the prevalence of the proportion of cells of one size or another can be used to judge a specific type of disease.

The abbreviation RDW in a blood test indicates the degree of distribution of red blood cells by volume (red cells distribution width). The second name of this indicator is the erythrocyte index. Using this parameter, specialists determine the degree of heterogeneity of the cell volume in the peripheral blood. In this case, attention is paid exclusively to red blood cells.

In the blood of every person, in addition to normal red blood cells, there are cells that differ in size: large cells are called macrocytes, small cells are called microcytes.

  • Iron-deficiency anemia;
  • sideroblastic anemia;
  • B12 folate deficiency anemia;
  • hypovitaminosis A;
  • massive blood loss;
  • blood transfusion;
  • damage to the red bone marrow with a change in pluripotent stem cells;
  • oncological diseases;
  • chronic liver disease;
  • pregnancy;
  • hypothyroidism;
  • some acute intoxication; and etc.

Anisocytosis in a general blood test: what is it? causes, symptoms

So, most likely you have anisocytosis if:

  • constant apathy and a breakdown that does not pass over a significant period of time;
  • depressive syndrome against the background of general well-being;
  • you notice shortness of breath in yourself that you did not have before;
  • palpitations even in a state of absolute rest; The condition appears suddenly, just as suddenly passes. Reminds attacks of vegetative-vascular dystonia.
  • periodically pale skin of the hands, face, cyanosis of the nails;
  • frequent headaches, accompanied by tinnitus;
  • insomnia appeared, appetite disappeared

The child may experience a decline in activity, a refusal of outdoor games.

All this happens because cells that have been modified in size do not allow blood to circulate normally and fulfill their direct duties of transporting nutrients.

For treatment, the doctor prescribes drugs that lower the level of anisocytosis and improve blood quality.

In medicine, it is clearly indicated what anisocytosis is, and what it is not. Anisocytosis is not an independent nosology, since this is a phenomenon, the process of changing the size of the diameter of blood cells, indicating the presence of a problem in the body.

Anisocytosis is detected by a general blood test during a microscopic examination. Modern equipment of hematological laboratories allows for the quantitative assessment of anisocytosis. The blood cells listed above must be of a certain size. The diameter of the red blood cell is normally 7,1-9,1 microns (micrometers), the diameter of the leukocytamm and the diameter of the platelet is 3-4 microns.

The specifics of the clinical manifestation and severity directly depend on the type and type of anisocytosis. Pathologically altered cells got their names in medicine.

For example, red blood cells, in which the normal diameter is 7,1-9,1 microns, we can distinguish:

  • normocytes – cells corresponding in size to the norm;
  • microcytes – cells having a diameter less than 7,1 microns;
  • macrocytes – cells that exceed a diameter of 9 microns;
  • megalocytes are cells that significantly exceed the normal size (their diameter starts at 12 microns).

The predominance of microcytes, macrocytes, and even more megalocytes in the blood is a clear indicator of anisocytosis of a particular type of cell, which is divided into:

  • microanisocytosis (microcytosis) – the predominance of microcytes in the blood, that is, cells having a diameter less than normal;
  • macroanisocytosis (macrocytosis) – the predominance of macrocytes in the blood – cells with an increased diameter.

The process of anisocytosis is divided into stages:

  • at stage I, the number of pathological cells in the blood does not exceed 50% of the total;
  • in stage II, this figure is between 50% and 70%;
  • at stage III, the number of pathological cells exceeds 70%.

Thus, if a microscopic analysis of a blood smear reveals approximately 60% of red blood cells with a diameter of 6,5 microns, then the doctor will record on the outpatient card that the patient has stage II red cell microcytosis.

Types and degrees of anisocytosis

Anisocytosis is classified depending on which types of blood cells are altered. Pathology has the following classification:

  • mixed type anisocytosis. Here, the test material contains up to 50% of macro- and microcytes;
  • microcytosis – the diameter of blood cells is less than 6,7 microns;
  • macrocytosis is a state with a predominance of macrocells, their diameter is more than 7,8 microns;
  • megalocytosis – the cell size exceeds 12 microns.

In various conditions, the shape and size of blood cells changes.

In addition, the rdw indicator of blood is distinguished depending on the degree:

  • (I) – the number of altered red blood cells is not more than 25% – micro anisocytosis is insignificant;
  • (II) – the number of altered cells from 25% to 50% is moderate, that is, the number of blood cells with an irregular shape is increased moderately;
  • (III) – the number of red blood cells having the wrong size or shape is from 50% to 75% – expressed;
  • (IV) – all red blood cells have an altered form – pronounced anisocytosis.

Given this classification, the doctor can give a conclusion, for example, mixed type anisocytosis is moderate, which means that the blood contains macro- and microparticles with a modified size, and their total number is not more than 50%.

  • mixed type anisocytosis. Here, the test material contains up to 50% of macro- and microcytes;
  • microcytosis – the diameter of blood cells is less than 6,7 microns;
  • macrocytosis is a state with a predominance of macrocells, their diameter is more than 7,8 microns;
  • megalocytosis – the cell size exceeds 12 microns.

In various conditions, the shape and size of blood cells changes.

Important! The pronounced anisocytosis almost always indicates the development of severe pathologies in the body.

Features of the course in children and pregnant women

In a newborn, physiological macrocytosis is often noted. This is explained by age features. As a rule, during the first 2-3 weeks of life, blood counts are normalized on their own without additional treatment. In addition, moderate anisocytosis in children can occur due to the transfer of infectious diseases. The norm rises slightly, after recovery, the blood formula is restored.

Anisocytosis during pregnancy often develops against a background of anemia due to a lack of iron in the body. Corrected blood counts in women in position using proper nutrition and taking iron-containing drugs.

Often anisocytosis develops in children against a background of various infectious diseases

Pronounced physiological macrocytosis is observed in newborns during the first 2 weeks of life, the blood formula independently normalizes within 1-2 months.

After infectious diseases in young children, reactive moderate anisocytosis is noted.

During pregnancy and breastfeeding in women, mild microcytosis or, on the contrary, megalocytosis is sometimes detected, which can signal the development of anemia.

At each specific age, the presence of distorted shaped elements in the blood of a child speaks differently.

So, for example, anisocytosis in a nursing baby is considered the norm. This is his physiological feature. The pathology itself will disappear two months after birth.

In children of absolutely any age, anisocytosis in the blood can be detected after an infection. This is also not a difficult case, and you should not sound the alarm. This happens against the background of anemia after the disease. Taking the necessary medications and vitamins will soon normalize the values.

For pregnant women, a red blood cell diameter of 11,5-14,5 is considered the norm. With any form of anisocytosis, the level of iron is lowered, which leads to iron deficiency anemia. Most likely, a future mother will be prescribed a number of iron preparations and a whole vitamin complex.

In order not to become a victim of circumstances, take care of your health in advance. Remember that anisocytosis can be prevented by a number of preventative measures.

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The permissible number of modified red blood cells and platelets during pregnancy should not exceed 14,5%. If this indicator far exceeds the indicated values, the cause may be iron deficiency anemia – a frequent pathology of pregnant women, which can lead to serious malformations of the fetus and complications during childbearing.

It is very important to take a general blood test in the third trimester (preferably 2-4 weeks before the expected birth). Platelet anisocytosis in late pregnancy can provoke increased bleeding during childbirth and in the postpartum period, since red blood plates are responsible for blood coagulation.

It is very important to take a general blood test in the third trimester of pregnancy

Important! To minimize the likelihood of complications during the bearing of the child and in the postpartum period, a woman should eat right and treat infectious diseases (especially viral) in time.

The daily diet must necessarily include foods rich in iron: pomegranate juice, steam veal, apple puree, buckwheat, tomatoes. If anisocytosis is diagnosed in the newborn in the first days of life, do not worry – this condition is considered normal for infants in the first 3-7 days after birth.

Anisocytosis can be diagnosed in newborns

Often anisocytosis develops in children against a background of various infectious diseases

Red blood cell anisocytosis and diagnosis of anemia

  • in the morning before taking the test you can’t eat and drink, the evening before dinner should be light, not contain spicy, fatty, salty, smoked food;
  • the day before the blood sampling, you can not play sports, take alcohol, go to the pool, sauna;
  • before blood donation, all medications are canceled;
  • repeated analysis is preferably carried out at the same time of day. Just before the procedure you need to catch your breath, calm down.

If you neglect these recommendations, the analysis will be inaccurate, which will cause difficulty in making a diagnosis.

  • A shift towards macrocytes indicates a rejuvenation of red blood cells and their incomplete maturation, which is usually associated with a lack of vitamin B12, folic acid, or other hematopoietic factors involved in hematopoiesis. In this case, we can talk about megaloblastic or macrocytic anemia;
  • A large number of small cells – microcytes (or anisocytosis with a predominance of microcytes) may indicate the direction of erythropoiesis towards micronormoblasts, which occurs when the body contains insufficient iron (iron deficiency anemia) or other specific components – microcytic anemia;
  • With regard to the norm – everything is not so clear. A normal level of anisocytosis does not mean the absence of pathology, which, for example, occurs in the case of aplastic anemia or anemic conditions associated with chronic pathology.

In addition, to obtain the completeness of the red blood picture, the red blood cell anisocytosis, given by the analyzer in digital terms, is compared with the histogram data reflecting the frequency of occurrence of cells of different volumes.

In rare cases, additional diagnostics are required – compiling a Price – Jones histogram (distribution of red blood cells by diameter). The erythrocytometric curve in healthy people has a regular triangular shape with a high apex and narrow base, erythrocytes with a diameter of 6-8 microns, which make up 70-75% of all red blood cells, predominate.

Micro and macrocytes are found in approximately the same amount (12-15%). The width of the erythrocytometric curve reflects the degree of anisocytosis, and the position of the maximum is the average diameter of the red blood cell. With microcytosis, the curve shifts to the left, becomes asymmetric, its width increases. With macrocytosis, the Price – Jones curve shifts to the right, flattenes, its base expands.

The main diagnostic method is a blood test for all indicators. It indicates the characteristics of the blood composition, indicators of red blood cells and platelets, necessary in order to detect anisocytosis. The erythrocyte index can be found by the line, which is called the coefficient of variation of the volume of red blood cells and the average deviation of the volume of red blood cells. A characteristic line for platelet research is the average platelet volume and platelet anisocytosis index.


Doctors offer each patient to change the nutrition system and diet, which includes minerals and vitamins, as soon as possible. Junk food should be removed from the diet so that the body does not waste its resource on “cleansing” of the products of its decay.

Without serious diseases, a simple change in diet and lifestyle without bad habits, the sleep necessary for the body, will help the patient get rid of anisocytosis. Very often, doctors recommend taking medications containing iron and vitamin B12, which are in short supply in the body.

Anisocytosis treatment is carried out depending on the disease that provoked a violation of the blood composition. Modern technologies used in medical practice, can accurately determine the disease that caused the violation. With anisocytosis of red blood cells, it is more often about iron deficiency anemia. In this case, the patient is prescribed a special diet, including products with a sufficient iron content and medications that restore hemoglobin.

If a large number of cells with an uncharacteristic size and shape are found in the blood against a background of colds and infectious diseases, detoxification therapy is carried out, efforts are aimed at suppressing cells that cause intoxication of the body, increasing immunity.

Anisocytosis, provoked by anemia, requires the introduction of iron-containing products into the human diet

If oncology is detected, a person is prescribed surgical treatment, radiation and chemotherapy. The earlier the pathology is identified, the more likely it is to cope with it, to avoid metastasis, the death of the patient.

Since anisocytosis is a marker of the pathological process, and not an independent disease, its special treatment is not carried out.

If a large number of cells of an uncharacteristic size are found in the general blood test, the patient is recommended to consult specialists, instrumental and laboratory studies to clarify the diagnosis.

After identifying the causes of anisocytosis and making the correct diagnosis, specific therapy is prescribed:

  • vitamin and iron preparations – with anemia;
  • detoxification therapy;
  • chemo- or radiation therapy – in oncological processes;
  • thyroid drugs;
  • vitamin preparations; etc.

After successful treatment of the underlying disease, the phenomena of anisocytosis are eliminated.

There is no specific treatment for anisocytosis. Correction of disorders is aimed at treating the underlying disease and preventing its recurrence. If the cause of the deviations is anemia, the patient is prescribed iron supplements and a diet rich in iron-containing foods. It is useful to include red types of meat (lamb, beef, pork, veal), apple and pomegranate juice, sunflower and pumpkin seeds, and liver on the menu.

Natural Pomegranate Juice

Particularly careful about their own health is necessary for women suffering from menorrhagia – heavy and prolonged menstruation. Large blood loss leads to increased loss of iron and the development of anemia, so during this period it is important to enrich the diet with foods with a high iron content.

In case of uterine bleeding (for example, against the background of cancellation of oral contraceptives), it is necessary to control the level of hemoglobin and the chemical composition of the blood in order to notice the deviations in time and take measures.

After stopping the attack, a woman is prescribed a special diet and drugs that make up for the lack of iron in the body, and a sparing regimen.

Anisocytosis is not a disease, but may indicate serious disturbances in the functioning of the body. To avoid pathology, it is important to eat right, move more and walk in the fresh air. Movement helps cells to better absorb and transfer oxygen molecules involved in the absorption of iron.

Hiking is very helpful.

In case of viral infections, even if this is a common ARI, you should not self-medicate, as improper treatment can cause complications and cause a violation of the structure and appearance of the formed components of the blood.

Anisocytosis treatment is carried out depending on the disease that provoked a violation of the blood composition. Modern technologies used in medical practice, can accurately determine the disease that caused the violation. With anisocytosis of red blood cells, it is more often about iron deficiency anemia. In this case, the patient is prescribed a special diet, including products with a sufficient iron content and medications that restore hemoglobin.

Anisocytosis, provoked by anemia, requires the introduction of iron-containing products into the human diet

Preventive measures

Anisocytosis is not an independent pathology, but only signals the development of other diseases of the body, therefore, due attention should be paid to the prevention of this condition. To avoid changes in blood composition, the following preventive measures should be followed:

  • Correct nutrition, saturate the diet with food containing a sufficient amount of iron;
  • take a blood test regularly;
  • timely treatment of infectious diseases;
  • to refuse from bad habits;
  • pay due attention to sports. Physical activity favorably affects the metabolic processes of the body, which positively affects the composition of the blood;
  • if you find such signs as weakness, fatigue, apathy, you must inform your doctor.

By adhering to a healthy lifestyle, serious diseases can be prevented. Proper nutrition, hardening and sports can strengthen the immune system, prevent the development of severe pathologies.

Stages and types of anisocytosis

Anisocytosis is a deviation from the norm, which can be divided into degrees, according to its severity:

  • 1st degree – slight or moderate, in which thirty to fifty percent of microcytes or macrocytes are observed in the blood.
  • 2nd degree – medium, red blood cells comprise fifty to seventy percent microcytes or macrocytes.
  • 3rd degree – sharp or pronounced, red blood cells consist of more than seventy percent of microcytes or macrocytes.

Features of mixed type anisocytosis

With a mixed type of change in the size of blood cells, the total number of macro and microcytes in the blood does not rise above 50%. The Price-Jones curve will help to identify this. If we talk about mixed anisocytosis, then macrocytes will prevail in the blood. More often diagnosed with pernicious anemia, or anemia caused by a deficiency of vitamin B12.

The normal RDW is an average of fourteen to eighteen percent. Deviation caused by a decrease or increase in platelet size can be mild to moderate.

This type of pathology of the shaped elements is characterized by the simultaneous presence in the blood of enlarged and reduced cells, that is, macrocytes and macrocytes are contained in approximately the same proportions. Most often, a mixed type of anisocytosis with a predominance of microcytes is found.

Allocate 4 degrees of severity. Denote them conditionally by pluses. The more pluses, the harder the pathological signs.

There is still anisocytosis of a mixed type, when micro and macrocytes are simultaneously detected in the blood. This phenomenon is less common in the presence of 2 or more diseases at the same time or simply with a lack of folic acid in the body.

The mixed type of anisocytosis is usually divided into 4 degrees of severity, designating each according to the number of pluses, which more clearly determines the degree of the pathological process compared with the division into stages:

  • 1 plus sign () – insignificant anisocytosis, in which altered cells are present in the blood in an amount up to 25%;
  • () – moderate anisocytosis, when the number of cells with sizes beyond the norm reaches already half of all available;
  • designation – a pronounced degree when the diameter of 75% of all cells differs from the permissible values;
  • 4 pluses () – a severe degree of mixed anisocytosis, i.e. more than 75% of blood cells have diameters that are not acceptable for the norm.

Development basis

Platelet sizes vary for various reasons. In myeloneoplastic processes, a serious increase in cell diameter is observed. Platelet size decreases with disseminated intravascular coagulation syndrome, aplastic anemia, impaired liver function, leukemia, and some other diseases.

Changing the size of red blood cells most often becomes one of the symptoms of anemia. Often such a diagnosis is made to children. Often, deviation is noted as a sign of hypochromia, posthemorrhagic anemia, and chlorosis, which indicates processes of degeneration in the blood. This syndrome does not have an independent character. Other causes of anisocytosis:

  • insufficient amount of vitamin A;
  • vitamin B deficiency12 and iron;
  • blood transfusion.

Anisocytosis in the latter case goes away on its own. The body adapts to the so-called “updated” blood, and diseased cells are replaced by healthy ones.

The eyes of the doctor are irreplaceable

Any of the most “smart” analyzer, meanwhile, does not cancel the work of laboratory diagnostics doctors, whose functional responsibilities include carrying out hematological studies. Placing the sample in the apparatus, the laboratory assistant simultaneously prepares (paints and dries) a smear intended for visual viewing (a doctor’s eye microscope) and determining the degree of anisocytosis of red blood cells.

blood anisocytosis, erythrocytes – different sizes

If in the preparation the whole field is covered with cells of approximately equal volumes (normocytes), then no markings are made about the anisocytosis in the hemogram form. This indicator is reflected in a general blood test if abnormal red blood cells claim to be widespread in a smear. It is clear that if the doctor sees small cells, he indicates anisocytosis with a predominance of microcytes, if large – notes macrocytosis.

It should be noted that such circumstances sometimes cause the laboratory diagnostics doctor to return to using a graphical expression of these parameters (or the Price-Jones curve).

In addition, it is not in vain that the term “degree of anisocytosis of red blood cells” is used, it is really distinguished by degrees, highlighting:

  1. Slight anisocytosis – abnormal cells occupy up to 1/4 part (up to 25%) in a blood smear, the result can be expressed by one plus ();
  2. Moderate – abnormal cells within half of the entire community that fell into the smear (up to 50%), or the result:;
  3. Expressed – 3/4 of all red blood cells take over cells with a changed volume (up to 75%) or the result:;
  4. High (acute) degree of anisocytosis – abnormal cells almost occupy the entire field (up to 100%), the result can be expressed by 4 pluses ().

At the same time, despite the complexity of the situation, you should not try to compare the Price-Jones curve, since it still had to be “drawn”, and the histogram provided by the analyzer, because the first reflects the size distribution by diameter, and the second by volume, therefore two Methods have a number of differences and features.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.