Grading the Severity of Schistocytosis

 

The examination is performed under oil immersion (100x objective) with 200 cells counted.

 

When evaluating schistocytosis it is important not to include:

(1) red cell fragments from iron deficiency

(2) schistocytes generated in vitro

(3) sickled cells associated with a hemoglobinopathy

 

Percent Schistocytes	Grade
0%	none
< 1.30%	occasional
1.30 to 4.79%	mild
4.80% to 9.60%	moderate
> 9.60%	severe

 

Severe hemolytic anemia may not show a large number of schistocytes if:

(1) the spleen and liver rapidly remove the fragements

(2) hemolysis is complete with no circulating fragments