Original MICA image-reading exercise, unscored. No clinical narrative absent from the source is added.
- Describe visible findings before proposing an interpretation.
- Suggest an interpretation and at least one image limitation.
- Which clinical findings or investigations would complement this observation?
Reveal the explained reading
Schistocytes · blood film
- Cell
- Erythrocyte fragment
- Shapes
- Helmet, triangle, angular fragment
- Method
- Standardised counting
- Direction
- Mechanical or microangiopathic haemolysis
Morphological description
Look for angular, triangular or helmet-shaped fragments; document a percentage rather than an isolated visual impression.
Causes and diagnostic direction
In adults, more than 1% schistocytes is suspicious for thrombotic microangiopathy under ICSH recommendations.
Differential diagnoses
Schistocytes may accompany other mechanical haemolytic processes or diseases; they do not identify a particular microangiopathy.
Pitfalls and limitations
Contextualise the threshold, particularly with other erythrocyte abnormalities; a single field cannot provide a count.
Take-home message
Identify, quantify and interpret fragments with haemolysis testing; do not conclude from their presence alone.
Sources
- ICSH | 2021 Update of the 2012 Recommendations for Identification, Diagnostic Value, and Quantitation of Schistocytes ↗
- The Clinical Significance of Schistocytes: A Prospective Evaluation of the International Council for Standardization in Hematology Schistocyte Guidelines - PMC ↗
- How Should Complicated Cases of Thrombotic Thrombocytopenic Purpura With Positive Coombs Test Be Treated? · Figure 1 ↗
Documentary review: 2026-10-15
Media source & rights
- Author
- Moutaz Ghrewati; Anas Mahmoud; Tala Beilani; Karam Zakharia; Mehandar Kumar
- Original source
- Moutaz Ghrewati; Anas Mahmoud; Tala Beilani; Karam Zakharia; Mehandar Kumar · How Should Complicated Cases of Thrombotic Thrombocytopenic Purpura With Positive Coombs Test Be Treated? · Cureus 2023;15(12):e50742, Figure 1 · CC BY 4.0 · https://assets.cureus.com/uploads/case_report/pdf/210009/20250210-74301-7pi8xp.pdf
- Licence
- CC BY 4.0
- Changes
- Full original field and annotations retained; WebP conversion, EXIF/GPS metadata removed, proportional derivatives without upscaling, cropping or medical retouching.
- Dimensions
- 2892 × 2184 px
- Check
- 2026-10-15