Flash information
- Cell
- Erythrocyte fragment
- Shapes
- Helmet, triangle, angular fragment
- Method
- Standardised counting
- Direction
- Mechanical or microangiopathic haemolysis
Definition
Schistocytes are erythrocyte fragments produced by mechanical fragmentation and showing characteristic shapes.
Examination or reading method
Perform standardised microscopic counting while considering the film’s other morphological abnormalities.
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.
Associated findings
Correlate anaemia, thrombocytopenia, LDH, bilirubin, haptoglobin, renal function and clinical manifestations.
Red flags
Schistocytes with thrombocytopenia and haemolysis warrant prompt assessment for a potentially severe syndrome.
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