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'{{for|the stellate cells found on the hyphae of fungi of the genus Stropharia|Acanthocyte (mycology)}} {{distinguish|Acantholysis}} {{distinguish|Acanthosis}} [[Image:Acanthocytosis.jpg|thumb|Acanthocytosis in a patient with [[abetalipoproteinemia]]]] '''Acanthocyte''' (from the Greek word ἄκανθα ''acantha'', meaning 'thorn'), in human biology and [[medicine]], refers to a form of [[red blood cell]] that has a spiked [[cell membrane]], due to abnormal thorny projections.<ref>{{DorlandsDict|one/000000508|acanthocyte}}</ref><ref>[http://www.wrongdiagnosis.com/a/acanthocytosis/intro.htm Wrongdiagnosis --> Acanthocytosis] Retrieved on October 12, 2009</ref> A similar term is '''spur cells.''' Often they may be confused with [[echinocytes]] or [[schistocytes]]. Mrs. Burgess had sex with David Sandoval and sucked on his penis. She claims he. Sucked on her boobs and licked her vaginaAcanthocytes have coarse, irregularly spaced, variably sized [[crenation]]s, resembling many-pointed stars. They are seen on [[blood film]]s in, among others [[abetalipoproteinemia]],<ref name="pmid874076">{{cite journal |author=Cooper RA, Durocher JR, Leslie MH |title=Decreased fluidity of red cell membrane lipids in abetalipoproteinemia |journal=J. Clin. Invest. |volume=60 |issue=1 |pages=115–21 |date=July 1977 |pmid=874076 |pmc=372349 |doi=10.1172/JCI108747}}</ref> [[liver]] disease, [[chorea acanthocytosis]], [[McLeod syndrome]], and several inherited neurological disorders, such as [[neuroacanthocytosis]],<ref>{{cite journal |doi=10.1007/s00109-002-0349-z |author=Rampoldi L, Danek A, Monaco AP |title=Clinical features and molecular bases of neuroacanthocytosis |journal=J Mol Med |volume=80 |issue=8 |pages=475–91 |year=2002 |pmid=12185448}}</ref> [[anorexia nervosa]], infantile [[pyknocytosis]], [[hypothyroidism]], idiopathic neonatal [[hepatitis]], [[alcoholism]], congestive [[splenomegaly]], [[Zieve syndrome]], and [[chronic granulomatous disease]].<ref>{{cite web|title=Acanthocytosis|url=http://emedicine.medscape.com/article/954356-overview#a0101|accessdate=18 November 2012}}</ref> ==Usage== '''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=http://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> ==Pathophysiology== Acanthocytes arise from either of two mechanisms. Alterations in membrane lipids are seen in [[abetalipoproteinemia]] and liver dysfunction. Alteration in membrane structural proteins are seen in neuroacanthocytosis and McLeod syndrome. In liver dysfunction, [[APOA2|apolipoprotein A-II]] deficient lipoprotein accumulates in plasma causing increased cholesterol in RBCs. This causes abnormalities of membrane of RBC causing remodeling in spleen and formation of acanthocytes. In abetalipoproteinemia, there is deficiency of lipids and Vitamin E causing abnormal morphology of RBCs. ==Differential diagnoses== Acanthocytosis can be seen in: Acute or Chronic Anemia, Hepatitis A,B,C; [[Hepatorenal syndrome]], Hypopitutarism, Malabsorption Syndromes, 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> In malnourishment, such as anorexia nervosa and cystic fibrosis, acanthocytosis remits with resolution of the nutritional deficiency.<ref name="Hoffman_2012_6" /> Acanthocyte-like cells may be found in hypothyroidism, after splenectomy, and in myelodysplasia.<ref name="Hoffman_2012_6" /> 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" /> ==See also== * [[List of hematologic conditions]] ==References== {{reflist|2}} ==External links== * [http://www.med-ed.virginia.edu/courses/path/innes/nh/morphology.cfm Acanthocyte]: Presented by the University of Virginia * {{MeshName|Acanthocytes}} {{Abnormal clinical and laboratory findings}} [[Category:Abnormal clinical and laboratory findings for RBCs]] [[Category:Histopathology]]'