Acanthocyte: Difference between revisions

'''Spur cells''' may refer [[synonym]]ously to acanthocytes,<ref name="Hillman_2011_5">{{Cite book | last=Hillman | first=RS |author2=Ault, KA|author3= Leporrier, M|author4= Rinder, HM.| title=Hematology in Clinical Practice | publisher=McGraw-Hill | year=2011 |chapter= |edition=5th | isbn=978-0-07-162699-6}}</ref> or may refer in some sources to a specific subset of 'extreme acanthocytes' that have undergone [[spleen|splenic]] modification whereby additional [[cell membrane]] loss has blunted the spicules and the cells have become [[spherocyte|spherocytic]] ('spheroacanthocyte'), as seen in some patients with severe liver disease.<ref name="UTD">Mentzer WC. Spiculated cells (echinocytes and acanthocytes) and target cells. UpToDate (release: 20.12- C21.4) [http://www.uptodate.com/contents/spiculated-cells-echinocytes-and-acanthocytes-and-target-cells]</ref>

'''Acanthocytosis''' can refer generally to the presence of this type of crenated red blood cell, such as may be found in severe cirrhosis or pancreatitis,<ref name="Hillman_2011_5" /> but can refer specifically to [[abetalipoproteinemia]], a clinical condition with acanthocytic red blood cells, neurologic problems and steatorrhea.<ref name="Harrison_2012_18">{{Cite book | last=Longo | first=D |author2=Fauci, AS|author3= Kasper, DL|author4= Hauser, SL|author5= Jameson, JL|author6= Loscalzo J.| title=Harrison's Principles of Internal Medicine | publisher=McGraw-Hill | year=2012 | chapter= |edition=18th | isbn=978-0-07174889-6}}</ref> This particular cause of acanthocytosis (also known as abetalipoproteinemia, apolipoprotein B deficiency, and Bassen-Kornzweig syndrome) is a rare, genetically inherited, autosomal recessive condition due to the inability to fully digest dietary fats in the intestines as a result of various mutations of the [[microsomal triglyceride transfer protein]] (MTTP) gene.<ref>{{cite web|url=httphttps://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002631/|title=Bassen-Kornzweig syndrome|last=Haldeman-Englert|first=C|author2=Zieve, D.|date=August 4, 2011|work=Pub Med Health|publisher=National Center for Biotechnology Information, U.S. National Library of Medicine}}</ref>

[[Image:Acanthocytosis.jpg|thumb|Acanthocytosis in a patient with [[abetalipoproteinemia]]]]
Acanthocytes arise from either ofalterations in membrane lipids or twostructural mechanismsproteins. Alterations in membrane lipids are seen in [[abetalipoproteinemia]] and liver dysfunction. Alteration in membrane structural proteins are seen in neuroacanthocytosis and McLeod syndrome.

In abetalipoproteinemia, there is deficiency of lipids and Vitaminvitamin E causing abnormal morphology of RBCs.<ref>{{cite web | last=Alarcon | first=Pedro A de | title=Acanthocytosis: Practice Essentials, Pathophysiology, Epidemiology | website=Medscape Reference | date=2024-01-17 | url=https://emedicine.medscape.com/article/954356-overview | access-date=2024-06-26}}</ref>

Acuteacute or Chronicchronic Anemiaanemia, Hepatitishepatitis A, B, and C;, [[Hepatorenalhepatorenal syndrome]], Hypopitutarismhypopituitarism, Malabsorptionmalabsorption Syndromessyndromes, Malnutritionand malnutrition.<ref name="de Alarcon_20111130">{{cite web|author = de Alarcon PA| title=Acanthocytosis|url=http://emedicine.medscape.com/article/954356-differential|date=Nov 30, 2011}}</ref>

Acanthocytes should be distinguished from [[echinocyte]]s, which are also called 'burr cells', which although crenated are dissimilar in that they have multiple, small, projecting spiculations at regular intervals on the cell membrane.<ref name="UTD" /><ref name="Hoffman_2012_6">{{Cite book | last=Hoffman | first=R |author2=Benz, EJ|author3= Silberstein, LE|author4= Heslop, H|author5= Weitz J|author6= Anastasi, J.|title=Hematology: Basic Principles and Practice | publisher=Elsevier | year=2012 | chapter=|edition=6th |isbn= 978-1-4377-2928-3}}</ref> Burr cells usually imply [[uremia]], but are seen in many conditions, including mild hemolysis in hypomagnesemia and hypophosphatemia, hemolytic anemia in long-distance runners, and [[pyruvate kinase deficiency]].<ref name="de Alarcon_20111130" /> Burr cells can also arise [[in vitro]] due to elevated pH, blood storage, ATP depletion, calcium accumulation, and contact with glass.<ref name="de Alarcon_20111130" /> Acanthocytes should also be distinguished from [[keratocytes]], also called 'horn cells' which have a few very large protuberances.<ref name="Hoffman_2012_6" />