Anisocytosis is a laboratory term for a significant or moderate change in the metric parameters of blood cells, which is a reflection of the development of pathological conditions or is observed as a physiological compensatory mechanism.
The change of any laboratory criteria in human examination is always a reflection of the change in the state of functioning of the organism as a whole, which is observed both in diseases and can be physiological compensatory changes. When examining the blood test for evaluating the composition of blood cells, attention should be paid not so much to changes in their numbers as to pathological irregularities in shape, size, and even color.
In a situation where the patient is diagnosed with anisocytosis in a blood test, there is a need for additional methods of laboratory diagnosis, since the detection of these changes is a reflection of the presence of a serious disease.
The average size of blood cells is within 7 - 7.5 microns, and therefore the slightest deviation in the parameters is a pathological anisocytosis (microcytosis, macrocytosis and megalocytosis).
Causes of anisocytosis
Since anisocytosis is not an independent nosological form, and is observed only as a reflection of pathological changes in a person, the role of the etiopathogenetic factor of its occurrence can be a wide range of diseases. So, the vitamin deficiency of group A and B, as well as the insufficient intake and synthesis of endogenous iron in the human body over time, provoke anisocytosis of erythrocytes, combined with a decrease in their content.
If there is a violation of blood transfusion techniques, during which no preliminary blood test was performed for the presence of altered blood cells, the anisocytosis in the recipient is also increased, but in most cases these changes are of a short duration and do not require medical intervention.
Various oncological pathologies, accompanied by metastatic damage to the bone marrow, as well as myelodysplastic syndrome , are manifested in almost 90% of the cases by the formation of blood cells, which differ not only in size but also in shape, so cancer patients are at risk for anisocytosis.
Any blood cell can be pathologically altered by metric parameters, except for the group of eosinophils. Transient compensatory anisocytosis can be observed with a long course of infectious diseases accompanied by a severe intoxication syndrome, and in this situation, the predominant anisocytosis of the blood cells of the leukocyte and lymphocyte series is observed.
Macrocytosis is most often observed with anemia due to vitamin B12 deficiency, diffuse liver and pancreatic parenchyma, and leukemia.
Symptoms of anisocytosis
Anisocytosis in almost all cases is accompanied by a decrease in the number of blood cells, so the clinical manifestations of this condition can not be considered specific, characterizing this pathology.
Practically all patients, in whom anisocytosis is detected by additional examination, note changes in the state of their own health in the form of progressive weakness, inability to perform the usual physical activity, rapid heart rate, observed against a background of complete well-being. With prolonged course, anisocytosis, combined with anemia and thrombocytopenia , provokes the development of respiratory disorders in the patient, manifested in an increasing inspiratory dyspnea of inspiratory type. With an objective examination of the patient, the paleness of the mucous membranes and skin can be expressed up to the development of acrocyanosis . Due to the fact that the above symptomatology is not specific and can accompany the development of cardiac diseases, it is necessary to conduct a comprehensive examination of the patient using not only laboratory but also instrumental imaging methods.
The degree of severity and specificity of clinical manifestations directly depend on the pathomorphological type of anisocytosis, therefore, when the changes in metric parameters of blood cells are detected, the "anisocytosis index" and "anisocytosis index" must be calculated. In a situation where the patient has a marked reduction or increase in the size of blood cells, the medical laboratory technician uses the terms "microcytosis" or "macrocytosis", but in some situations, one person may have both conditions, so the term "mixed type anisocytosis" should be used.
In addition to detecting the presence of anisocytosis, the expression of the changes is of great importance for a specialist in the field of hematology, therefore, for the separation of anisocytosis in degrees there is a generally accepted gradation represented by four degrees of severity. Minor anisocytosis is referred to in the laboratory analysis as "+" and is used when the content of the size-altered blood cells is within 25% of their total concentration. Moderate anisocytosis or "++" occurs when the content of altered blood cells is increased to 50%. The pronounced degree of anisocytosis "+++" is accompanied by severe clinical manifestations, as the number of altered blood cells prevails over the content of "healthy cell composition" (up to 75%). Critical anisocytosis or "++++" is extremely rare and is accompanied by a complete replacement of normal blood cells with altered ones.
Anisocytosis in children
If signs of macrocytosis in children of newborn age are found, it should be taken into account that this form of anisocytosis is physiological and signs of a change in the size of blood cells are independently leveled within two months. Also, anisocytosis in pregnancy is a frequent occurrence, and in the general population of altered blood cells, megalocytes predominate (cell sizes exceed 12 μm).
It should be taken into account that in the blood of an absolutely healthy child there can be a small amount of both microcytes and macro-cells, the concentration of which should not exceed 15% of the total cellular composition of the blood.
Due to the fact that in childhood there is an increased incidence of iron deficiency anemia , this pathological condition prevails among other causes of anisocytosis. When prescribing iron-containing drugs to the child in order to eliminate the signs of anemia, it should be taken into account that in the initial stage of treatment the anisocytosis index may increase and this condition is caused by the rapid filling of erythrocyte cells with hemoglobin. After normalization of the hemoglobin concentration in the child's blood, the anisocytosis index normalizes independently.
Anisocytosis of blood cells of a platelet in the form of a decrease in their size, as a rule, accompanies the development of thrombocytopathy, thrombocytopenia and hypoplastic syndrome.
In addition to determining the degree of anisocytosis, the erythrocyte distribution index is applied to the anisocytosis of erythrocyte cells, which is calculated by the method of determining the difference between the minimum and maximum erythrocyte size.
Treatment of anisocytosis
Elimination of signs of anisocytosis occurs when levels of underlying background disease are leveled, if possible. In a situation where the anisocytosis of erythrocytes is a manifestation of iron deficiency or folio-deficient anemia, etiopathogenetic treatment consists in correcting the eating behavior of the patient (enriching the daily menu with products containing iron, B vitamins in sufficient concentration), and with a severe degree of using medication (Cyanocobalamin dose 500 mg intramuscularly, Fereplex in a daily dosage of 150 mg).
In a situation where anisocytosis develops as a result of the development of the tumor process in the patient, pathogenetically grounded therapy of the background disease, which involves the use of chemotherapy drugs, as well as surgical treatment, is applied. In some cases, it is advisable to use expectant management for anisocytosis, since the change in the shape of blood cells can have a short-term course and self-level without specific treatment.
? Anisocytosis - which doctor will help ? If there is or suspected anisocytosis, you should immediately seek advice from such physicians as a therapist and a hematologist.