Why is the rate of erythrocyte anisocytosis higher than normal and what to do. Anisocytosis in a general blood test: is it dangerous? Mixed anisocytosis in a general blood test

Anisocytosis of erythrocytes is of great interest for the diagnosis of various diseases.

Often patients do not know what it is and think that doctors have discovered a serious disease in them when they hear about anisocytosis of erythrocytes or platelets.

What does this abbreviation represent, why do doctors need to determine the indicators of erythrocyte anisocytosis, and what normal values ​​does it take?

It is known that red blood cells perform their special work in the human body.

The main tasks of red blood cells are considered to be the exchange of oxygen between human tissues and internal organs.

In this case, of diagnostic interest is not only a change in the total number of certain types of blood cells, but also the reasons for changes in their shapes and sizes in a given volume of blood serum.

Anisocytosis of erythrocytes is a phenomenon in which red blood cells change their size and shape towards increasing or decreasing.

Small red blood cells with a diameter of less than 7 microns are called microerythrocytes, or microcytes.

If the diameter of red blood cells is more than 8 microns, then such cells are considered macroerythrocytes, or macrocytes.

In the case when red blood cells increase even more and reach sizes exceeding 12 microns, they are called megalocytes.

Red blood cell anisocytosis, or RDW, is used to measure the number of red blood cells that have changed in size in the blood.

It records how red blood cells are distributed across the width of a blood smear. The erythrocyte anisocytosis index is measured as a percentage.

In a healthy adult, regardless of gender and age, the number of normocytes should be at least 70% of the total volume of red blood cells in the blood.

The proportion of red blood cells of altered volume (microcytes, megalocytes and macrocytes) should account for approximately 15% of the total number of red blood cells.

Changes in the rate of erythrocyte anisocytosis can have exclusively physiological reasons.

For example, in infants under 6 months of age, the RDW ranges from 15% to 19%. After this age, a healthy child experiences a gradual increase in the number of normocytes in the blood until the anisocytosis index becomes the same as in an adult.

The RDW is also slightly exceeded in women expecting a baby, since pregnancy is characterized by a deficiency of normocytes in the blood.

The rate of anisocytosis in pregnant women can vary between 14% and 16%. This condition does not require special therapeutic measures, and RDW is normalized by a healthy lifestyle and taking vitamin and mineral complexes with increased iron content.

Causes of micro- and macrocytoses

However, often the presence of anisocytosis of erythrocytes indicates some kind of disease.

In this case, the indicators are divided according to the percentage of the number of cells with a changed diameter in a given volume of blood.

Anisocytosis occurs:

• first degree, if the number of micro- and macroerythrocytes in the blood is from 30% to 50% of the total number of red cells. In the decoding of analyzes it can be denoted by a “+” sign. This type of anisocytosis is considered minor;
• second degree, when the number of cells of increased and (or) decreased diameter is from 50% to 70% of the total number of red blood cells. Indicated by a “++” sign and considered moderate anisocytosis;
• third degree, if the changed cells occupy more than 70% of the total volume. This type of erythrocyte anisocytosis is considered pronounced and is designated “+++”;
• fourth degree, when there are practically no normocytes in the blood, and the entire blood volume is occupied by micro- and macroerythrocytes. This condition is considered pronounced.

Moreover, depending on what size cells predominate in the blood, anisocytosis is divided into the following types:

• microcytosis (predominance of microerythrocytes in the blood);
• macrocytosis (high content of macroerythrocytes);
• mixed type anisocytosis (there are many large and small red blood cells in the blood).

The following pathologies may be the causes of microcytosis:

• hereditary diseases in which the synthesis of red blood cells in the bone marrow is disrupted;
• a general decrease in the number and size of red blood cells due to iron deficiency in the body;
• intoxication with lead or other poisons;
• deficiency of vitamins A and B₁₂;
• condition after major blood loss or blood transfusion;
• development of malignant neoplasms;
• hypochromic sideroblastic anemia;
• eating disorders.

Macrocytosis is usually observed in infants in the first days of life, after which by about two months the number of large cells in the baby's blood decreases and the baby's RDW returns to normal.

In adults, anisocytosis of the macrocytosis type can be observed as a result of the following pathological conditions:

• insufficient functionality of the thyroid gland, due to which the lipid membranes of red blood cells proliferate;
• liver hepatosis, including steatosis;
• alcohol addiction;
• myelodysplastic syndrome;
• erythrocyte leukemia;
• lack of cobalamin and folic acid in the body;
• chemotherapy with certain drugs;
• microspherocytosis;
• ischemic diseases;
• Alzheimer's syndrome.

In the case of mixed anisocytosis, when there are many micro- and macroerythrocytes in the blood, the causes of this condition can be both the above diseases and the state of the body in the acute period of chronic diseases and after viral and bacterial infections.

Treatment and prevention

Changes in the size of red blood cells are considered a marker of various types of anemia. The RDW index determines the severity of such pathologies.

However, during a course of treatment for iron deficiency anemia, as a rule, the RDW indicator always increases.

During this period, bone marrow tissue begins to produce large cells, which leads to macrocytosis.

After therapy, the size of red blood cells becomes normal, and the RDW indicator stabilizes.

A high RDW is of medical interest. If, when deciphering the CBC, it is discovered that this indicator is reduced, then you will have to donate blood again, because, most likely, some error occurred when deciphering the diagnostic data.

To calculate RDW, a histogram of the distribution of red blood cells, the so-called Price-Jones curve, is used.

In this process, a blood sample on a slide is placed under a microscope and the size of approximately one hundred red blood cells is measured.

It is very difficult to manually calculate the anisocytosis index, because you have to take into account the percentage of macro-, micro-, and normocytes in a given volume of blood, and also build a corresponding graph, which often leads to large errors in calculations.

Automatic blood analyzers have become a great help for hematologists, which immediately build an image of the anisocytosis curve and give an accurate and complete picture of changes in the size of red blood cells.

A blood test for anisocytosis is taken in the morning on an empty stomach. Adults can drink a glass of water; for young children, the ban on food is relaxed, but to reduce the likelihood of inaccurate interpretation, you should try not to feed the child for at least two hours before taking blood.

It is advisable not to be nervous and avoid heavy physical activity before donating blood. Blood for anisocytosis is taken from a finger.

If severe or pronounced anisocytosis is detected in the blood, then you should not be nervous, rush into panic and look for the causes of this condition.

The test results must be deciphered by a qualified hematologist, taking into account other data, the patient’s complaints about his condition and his medical history.

In parallel with RDW, the doctor also evaluates the average volume of red blood cells in the blood.

The opposite situation also happens when the RDW index is normal, but the person has the following diseases:

• Minkowski-Choffard disease, in which red blood cells, without changing their size, take on the shape of a ball;
• anemia as a consequence of chronic autoimmune processes;
• hereditary hemoglobinopathies.

Based on the above, it is clear that anisocytosis is not a separate disease, but a change in the size of red blood cells, which can have both purely physiological reasons and be a consequence of serious diseases.

Therefore, therapy should be aimed primarily at the cause of destabilization of the size of red blood cells.

If the causes of anisocytosis were not serious illnesses, but an unhealthy lifestyle, hypermenorrhea, deficiency of vitamins and minerals in the body, therapy with certain drugs, then the doctor usually prescribes the following measures to normalize RDW in the patient’s blood:

• healthy diet, which contains a lot of red foods - beef, pomegranates, apples, tomatoes;
• maintaining proper sleep and rest patterns;
• taking multivitamin complexes containing iron and vitamins A, B₁₂.

People who experience an increase in RDW every time they take tests need to be monitored by a hematologist on a regular basis.

Blood is the most important element of the hematopoietic system, which ensures the vital functions of the body and participates in metabolic processes. Blood is a constantly circulating fluid consisting of plasma and blood cells (suspended particles): red blood cells, white blood cells and platelets. Blood is connective tissue and performs the function of nourishing and providing all organs and systems with oxygen molecules, and also transfers processed carbon dioxide to the alveoli, from which it then comes out.

A complete blood count is a type of laboratory test that counts all blood cells, as well as their size and shape. CBC is included in the list of mandatory diagnostic tests in the treatment of any disease and allows you to detect signs of an inflammatory process if blood cell counts differ from the norm.

One of these parameters is particle size. If it does not correspond to normal values, “anisocytosis” is marked on the study form.

Changes in the size and shape of blood components do not always indicate pathological processes in the body. It is considered normal if the deviation does not exceed 30% of the total number of red and white blood cells, and their percentage ratio in relation to each other must also be taken into account - it should be approximately the same. In the vast majority of cases, anisocytosis occurs simultaneously with poikilocytosis, a condition in which the structure of red blood cells is deformed and their work is disrupted.

The standard size of red blood cells (blood cells that contain hemoglobin and provide gas exchange in the body) can range from 7 to 9 micrometers. If these numbers are less or more than the normal value, the person is diagnosed with anisocytosis, which can occur in several forms, which are classified according to the size of the predominant red blood cells.

When we talk about anisocytosis, in most cases we mean an excess of the number of red blood cells of non-standard size by more than 30% of the total number of red blood cells, but sometimes the changes also affect small spherical plates of red color - platelets. Platelets are responsible for blood clotting, and changes in their size are almost always caused by pathological processes in the body, which can have a sluggish course and are detected by chance during a general blood test.

If a patient is diagnosed with platelet anisocytosis, the doctor will definitely prescribe an additional examination to exclude diseases of the hematopoietic system (including oncological processes), severe viral pathologies and diseases accompanied by latent forms of inflammation. When diagnosing, the doctor also necessarily takes into account the degree of pathology, which depends on how much the deviations exceed the permissible norm.

You should know it! In deciphering the results of a complete blood count, erythrocyte anisocytosis and platelet anisocytosis are designated as RDW and PDW, respectively.

Why does anisocytosis occur?

Both fairly harmless factors that can be easily corrected (for example, a monotonous, unbalanced diet) and serious diseases, including malignant blood lesions, can lead to the development of pathology. If a person eats incorrectly, abuses semi-finished products, canned food, products with a large number of chemical additives (flavors, dyes, preservatives), red blood cells and platelets may slightly change their size, but serious deviations are usually not observed.

Various forms of anemia can negatively affect the structure and appearance of blood components, especially iron deficiency anemia, in which there is a decrease in the level of hemoglobin, a complex iron-containing protein, the main component of the red blood cell.

A lack of carotene, retinol, vitamins B12 and B6 can also cause changes in blood components.

Pathological causes of anisocytosis include:

An increase in anisocytosis may be caused by systematic exposure to radioactive radiation. This situation can be observed in cancer patients undergoing radiation therapy, and in workers of machine and shipbuilding enterprises, whose activities are related to the manufacture of parts for submarines, military equipment and missile equipment.

Note! In some cases, moderate anisocytosis may be present in viral infections, for example, infectious mononucleosis, influenza, rotavirus infection, viral hepatitis and other diseases caused by various groups of viruses.

Is it possible to recognize anisocytosis without a blood test?

To diagnose the pathology, you need to take a general blood test, for which capillary blood (from a finger) is used. This is the only reliable method, since no specific symptoms appear during anisocytosis.

The patient may notice some deterioration in health, but they are not typical for this pathology and may indicate other disorders in the body.

The main and constant signs of anisocytosis are:

• constant weakness that does not go away even after proper rest and a night’s sleep;
• decreased performance;
• moderate headaches localized in the upper part of the head and in the back of the head;
• increased drowsiness;
• muscle weakness after waking up in the morning.

If the disorders are not treated for a long time, more serious problems may join the existing manifestations - the so-called “cardiac syndrome”. A person’s pulse quickens, their heart rate increases, and they experience difficulty breathing and shortness of breath. The feeling of lack of air can occur at any time of the day, regardless of physical activity and body position. The number of attacks of uncontrollable shortness of breath usually ranges from 2 to 8 per day.

The skin of people with various forms of anisocytosis is usually pale. The same applies to the mucous membranes of the lips and oral cavity.

Important! If the patient suffers from shortness of breath, rapid heartbeat, or frequent headaches of unknown etiology, it is necessary to consult a doctor. If there are no pathologies during examination by a cardiologist, you should donate blood for analysis - perhaps the reason is anisocytosis or other disorders of the hematopoietic system, for example, a shift in the leukocyte formula or a deviation in hematocrit.

What does anisocytosis indicate in pregnant women?

The permissible number of modified red blood cells and platelets during pregnancy should not exceed 14.5%. If this indicator is much higher than the specified values, the cause may be iron deficiency anemia - a common pathology of pregnant women, which can lead to serious fetal malformations and complications during pregnancy.

It is very important to take a general blood test in the third trimester (preferably 2-4 weeks before the expected birth). Anisocytosis of platelets can, in late pregnancy, provoke increased bleeding during childbirth and in the postpartum period, since red blood platelets are responsible for blood clotting.

Important! To minimize the likelihood of complications during pregnancy and the postpartum period, a woman should eat properly and treat infectious diseases (especially viral ones) in a timely manner.

Your daily diet must include foods rich in iron: pomegranate juice, steamed veal, apple puree, buckwheat, tomatoes. If a newborn is diagnosed with anisocytosis in the first days of life, there is no need to worry - this condition is considered normal for infants in the first 3-7 days after birth.

Treatment and prevention

There is no specific treatment for anisocytosis. Correction of disorders is aimed at treating the underlying disease and preventing its relapses. If the cause of the deviation is anemia, the patient is prescribed iron supplements and a diet rich in iron-containing foods. It is useful to include red meats (lamb, beef, pork, veal), apple and pomegranate juice, sunflower and pumpkin seeds, and liver in the menu.

To eliminate or prevent vitamin deficiency, you can take mineral supplements or vitamin-mineral complexes, for example:

• "Pikovit";
• "Alphabet";
• "Complivit";
• "Vitrum".

Women suffering from menorrhagia – heavy and prolonged menstruation – need to be especially attentive to their own health. Large blood losses lead to increased loss of iron and the development of anemia, so during this period it is important to maximally enrich the diet with foods with a high iron content.

In case of uterine bleeding (for example, against the background of discontinuation of oral contraceptives), it is necessary to monitor the level of hemoglobin and the chemical composition of the blood in order to notice any deviations in time and take action.

After stopping the attack, the woman is prescribed a special diet and medications that replenish the lack of iron in the body, and a gentle regimen.

Anisocytosis is not a disease, but may indicate serious problems in the functioning of the body. To avoid pathology, it is important to eat right, move more and walk in the fresh air. Movement helps cells better absorb and transport oxygen molecules involved in the process of iron absorption.

For viral infections, even if it is a common acute respiratory infection, you should not self-medicate, since improper treatment can cause complications and cause disruption of the structure and appearance of blood components.

Video - Why platelet levels drop

In a healthy body, the normal level of red cells, also called red blood cells, cannot exceed 70 percent. A healthy red blood cell is between 7 and 12 microns in diameter. And ideally, a mature cell should be between 7-8 microns and it is called normocytes. When readings are below normal (7 µm) - microcytes or microerythrocytes, above normal (8 µm) - macrocytes and macroerythrocytes. And the indicator of erythrocyte anisocytosis is the fluctuation itself below or above the specified norm. In people in adulthood, fluctuations are considered stable within the range of 11.5 - 14.5 percent, and in a child up to six months within the range of 14.9 - 18.7 percent, then a process of decline occurs, to the normal level of an adult.

So what is red blood cell anisocytosis?

Red bodies in our body give us a very important role. The main task they perform is the transportation and exchange of oxygen throughout all internal organs and tissues of the human body.

The term anisocytosis is a laboratory term and refers to significant and moderate changes in red blood cells. Anisocytosis indicates that the level of red blood cells is increased or decreased, causing the body to malfunction, which can lead to a number of different diseases.

Causes and types.

Abnormalities in blood levels sometimes demonstrate the formation of myelodysplastic syndrome. Also, a lack of vitamins A and B12 or a lack of iron can over time cause anisocytosis, with a clear manifestation in a decrease in red blood cells.

The reason for the change in the level of red blood cells is sometimes an insufficient study of donor blood for abnormalities, but this, most often, is temporary and does not require treatment with medications. Another reason for changes in the level of red cells in the blood can be an oncological disease, in which not only the level of red blood cells changes, but in 90 percent, they begin to differ in their shape and size.

In addition to the fact that changes in red blood cells can be determined using capillary blood sampling from a finger, there are also a number of symptoms that can signal this disease:

• a person cannot work for a long time due to loss of strength
• nails and skin become pale
• Occasional shortness of breath may occur
• Even when at rest, a rapid heartbeat may develop.

There are four degrees of this disease:

• first (insignificant) - the number of macrocytes and microcytes ranges from 30 to 50%
• second (moderate) – amount from 50 to 70%
• third (pronounced) – above 70%
• fourth (sharply expressed) - almost all cells have an abnormal size from a stable one.

For laboratory tests, there is a certain gradation for all four types. So, for example: “+” is a slight change in red blood cells, “++” is moderate, “+++” is pronounced and “++++” is pronounced, which occurs in very rare cases.

Based on cell size, the disease is divided into three categories:

1. microcytosis (when the level of microred blood cells is increased)
2. macrocytosis (when the number of macroerythrocytes is high)
3. mixed type of anisocytosis (when the number of large and small red blood cells increases)

In their first days of life, babies may experience macrocytosis, but soon, after a couple of months, the level of large cells returns to normal. If this does not happen and the test index remains unchanged, then you should immediately contact doctors such as a therapist or hematologist, because it is in the early stages that the chance of identifying and preventing diseases such as Cooley’s syndrome and neuroblastoma is especially increased.

In adults, macrocytosis can be due to alcohol abuse, liver disease, in the absence of a spleen, it can also be caused by chemotherapy, etc. Microcytosis is also caused by hereditary diseases, most often those where the synthesis of bone marrow blood cells is impaired. Eating disorders, lack of vitamins A and B12, lack of iron, lead poisoning and other poisons also increase the risk of developing this disease.

A mixed type in changes in red blood cells can develop for the above reasons, as well as in connection with chronic diseases and after suffering bacterial or viral diseases.

Moderate anisocytosis, or a low level of red blood cells, is not a terrible disease, because it can be easily treated with a diet that recommends eating more red foods (apples, tomatoes, beef), and it is also recommended to increase the consumption of liver and buckwheat. In another case, a hematologist may prescribe the necessary medications and vitamins A and B12. At the same time, the rule of observing a sleep and rest schedule is also very important. If the disease manifests itself in a severe manner, the doctor prescribes the medications necessary for treatment, and if the cause is a malignant tumor, then the question arises of eliminating it, either through surgery or a course of chemotherapy.

During pregnancy.

During pregnancy and lactation, many women often experience iron deficiency anemia, which leads to an increase in the level of microcytes in the blood, which is directly related to the intrauterine development of the child. During pregnancy, you should monitor your blood tests very carefully. If the tests are ignored, then premature birth is possible, as well as hypoxia and fetal anomaly. It is also important to know that the mildest form of this disease can be a sign of serious pathologies.

Identification.

Blood is tested for anisocytosis by collecting capillary blood from a finger, always on an empty stomach and in the morning. Most often, modern hematological analyzers are used to determine the degree of deviations of red bodies, because it is extremely difficult to calculate the index manually. To do this, you need to take into account the content and norm of macro- and microcytes in the sampled volume of blood, then build the necessary graph, which leads to frequent and very significant errors in research.

Blood is the basis of all systems of our body. The state of our health is assessed by the state of the blood by taking a general analysis of the serum component. It is traditionally accepted that only quantitative enzymatic composition can indicate various abnormalities in the body. The size of the elements also plays a big role. You can often come across the concept of anisocytosis in a general blood test. What it is and how dangerous this phenomenon is, we will find out in our article.

The concept of anisocytosis

When seeing a strange diagnosis in a medical record, it is important to understand what anisocytosis is. Each element of blood, be it an erythrocyte, leukocyte or platelet, has its own size. This, coupled with the appearance of the particle, can indicate health problems.

Doctors have long been saying that only 30% (15+15) elements of non-standard size are acceptable in a blood test: some are larger, others are smaller. If the number of heterogeneous elements begins to increase, then a pathological process develops in the body. The doctor will determine how severe it is by the degree of imbalance between normal cells and cells that have increased in size.

Thus, anisocytosis is a pathological process of changing cell size. The most common are erythrocyte anisocytosis and platelet anisocytosis.

Cell modification itself is not a diagnosis. This is a guideline for the doctor and a signal for further action.

If even a slight deviation from the norm is detected, the doctor may prescribe an additional examination in order to rule out serious health problems. It is believed that the most common consequence of cell size changes is anemia.

Types and types of anisocytosis

The severity depends on the form of the pathology and the number of modified blood cells.

Medical designations for changed elements

This terminology is based on standard sizes of red blood cells.

The main division of anisocytosis according to the type of changed cells

• Platelet anisocytosis

It is characterized by an increase in the size of platelets - blood cells that are responsible for blood clotting.

In case of platelet anisocytosis, additional examination is prescribed to exclude diseases such as leukemia, severe viral pathologies, anemia, and radiation sickness.

• Anisocytosis of red blood cells

This type of deviation is associated with a change in the permissible size of red blood cells - blood cells that are actively involved in the supply of oxygen to organs and the removal of carbon dioxide. Red cells actively transport nutrients.

May indicate liver pathologies or a lack of vitamin B12.

In turn, this type of pathological changes is divided into three more types:

1. Microanisocytosis, which is characterized by a predominance of cells of smaller diameter (microcytes).
2. Macrocytosis, characterized by macrocytes, i.e. cells that are several times larger than the permissible size.
3. Anisocytosis of mixed type. It can be either with a predominance of microcytes or macrocytes. Let's talk about this type of deviation in more detail.

Features of mixed type anisocytosis

This type of pathology of the formed elements is characterized by the simultaneous presence of enlarged and reduced cells in the blood, that is, macrocytes and macrocytes are contained in approximately the same proportions. The most common type is a mixed type of anisocytosis with a predominance of microcytes.

There are 4 degrees of severity. Let's call them conventionally pluses. The more advantages, the more severe the pathological signs.

Why does anisocytosis occur?

Having found out what this phenomenon of anisocytosis is, it is important to understand the reasons for its appearance in the body.

• Incorrect or inadequate nutrition. As a rule, this factor does not cause serious changes in the formed elements. However, you shouldn't discount it. Poor nutrition and abuse of certain types of food provoke a lack of vitamins A and B, iron deficiency, which can lead to the development of anemia. This is especially common in children with poor appetite. To normalize the indicators, you need to eat meat, fresh fruits, vegetables, and fish. Vitamin B12 will increase the number of red cells, and vitamin A will restore the normal size of serum components.
• Consequences of blood transfusion. Before blood from a donor is sent for transfusion, it is necessary to test the biomaterial for anisocytosis. If this is not done, there is a risk of receiving non-standard blood cells as an inheritance from the former owner. Our immune system cannot normalize abnormalities overnight; this takes time. In this case, after a short interval, all elements will be the same in size.
• Cancerous tumors. It is known that the lion's share of cancer cells is synthesized in the bone marrow. This affects the state of the blood, in particular the development of anisocytosis.
• Pathologies of the liver, including oncology with metastases to the liver (most often the cause of macrocytosis)
• Thyroid diseases
• The process of hemoglobin synthesis is disrupted
• A syndrome characterized by an imbalance between new cells and dying cells. Typical for older people.
• Alcohol abuse
• Infections and inflammations of various types
• Presence of worms

Symptoms of the disease

There are a number of symptoms, if they appear, you should not delay your visit to the doctor and immediately take a general blood test.

So, most likely you have anisocytosis if:

• constant apathy and loss of strength that does not go away over a significant period of time;
• depressive syndrome against the background of general well-being;
• you notice shortness of breath that was not there before;
• heart rate increases even in a state of absolute rest; The condition appears suddenly and goes away just as suddenly. Reminiscent of attacks of vegetative-vascular dystonia.
• periodically the skin of the hands and face turns pale, and the nails become blue;
• frequent headaches accompanied by tinnitus;
• insomnia appeared, appetite disappeared

The child may experience a decline in activity and a refusal to play outdoor games.

All this happens because cells that have been modified in size do not allow the blood to circulate normally and fulfill its direct duties of transporting nutrients.

For treatment, the doctor prescribes drugs that reduce the level of anisocytosis and improve blood quality.

Anisocytosis in children and expectant mothers

At each specific age, the presence of distorted formed elements in the child’s blood indicates different things.

For example, anisocytosis in an infant is considered normal. This is his physiological feature. The pathology will disappear on its own two months after birth.

It turns out that doctors judge a person’s health status not only by the quantitative composition of the blood. Based on the type and size of red blood cells, platelets, and other cells in a general blood test, one can also draw conclusions about what changes are occurring in the body. Red blood cell anisocytosis or platelet anisocytosis is an unusual phenomenon that can occur in children and adults and leads to abnormal changes in the size of blood cells, which almost always means the development of some disease and requires additional testing and treatment.

Features of the disease

In a general blood test, any person has platelets, which are responsible for clotting, as well as leukocytes - white blood cells, whose function is to fight foreign particles and infection. No less important for humans are red blood cells, which carry oxygen and nutrients to cells and transport carbon dioxide. The morphology of red blood cells is not the same, that is, their different sizes are distinguished:

1. Normocytes are cells measuring 7.1-9 microns.
2. Micro red blood cells, or microcytes, are cells up to 6.9 microns in size.
3. Macrocytes are cells measuring from 8 microns.
4. Megalocytes are cells with a size of 12 microns.

If all indicators of red blood cells in the blood are not higher than normal, and the person is completely healthy, then normocytes make up no more than 70% of the total number of red blood cells, and the share of macrocytes and microcytes in total accounts for up to 15%. When an analysis reveals that any indicator is elevated or, conversely, below normal, this indicates disturbances in the body. If the number of large or small cells is increased, this reflects an increase in the RDW value. The same changes can occur in platelets. Otherwise, a person experiences anisocytosis.

By definition, anisocytosis is the process of changing the size of blood cells - red blood cells and platelets. Anisocytosis is a violation of the correct ratio of the size of these blood cells, which is determined by a general analysis. Even when anisocytosis is reduced, that is, weakly expressed, a number of additional studies are required to exclude serious diseases of the body. Despite the fact that in most cases this symptom is associated with anemia - a decrease in hemoglobin in red blood cells - the blood condition should be carefully monitored to exclude more serious pathologies.

Types and stages of anisocytosis

Anisocytosis is divided into degrees according to its severity:

1. Anisocytosis of the first degree is moderate or insignificant, red blood cells consist of 3-50% microcytes or macrocytes.
2. Anisocytosis of the second degree is moderate, red blood cells consist of 50-70% microcytes or macrocytes.
3. Anisocytosis of the third degree - pronounced, or sharp, red blood cells consist of microcytes or macrocytes by more than 70%.

In addition, the following types of diseases are distinguished:

1. Microcytosis.
2. Macrocytosis.
3. Mixed anisocytosis, including mixed anisocytosis with a predominance of microcytes or macrocytes.

As for the less common platelet anisocytosis, its search is based on the width of the distribution of these cells throughout the blood volume. The normal PDW indicator is 14-18%, and its deviation from the norm with a decrease or increase in platelet size can also be mild, moderate, or severe.

Reasons for development

Platelet size can change pathologically for various reasons. The most serious increase in cell diameter is observed during myeloneoplastic processes. A decrease in platelet diameter is observed in DIC syndrome, aplastic anemia, liver failure, leukemia and a number of other diseases. Isolated anisocytosis of red blood cells may be present in mild stages of anemia, for example, it may occur during menstruation, especially when it is delayed for any reason.

In general, anisocytosis of erythrocytes most often becomes a symptom of anemia, and the severity of the arrhythmia can be judged by its severity. This development of events is often diagnosed in children. Pathology is often noted as a sign of hypochromia (hypochromic anemia), posthemorrhagic anemia, chlorosis, and also as a symptom of hyperchromic anemia, indicating degenerative processes in the blood. This syndrome does not have an independent character. Other reasons for the development of anisocytosis may be:

• lack of vitamin A;
• deficiency of vitamin B12 and iron;
• cancer with metastases to the bone marrow;
• blood transfusion performed.

In the latter case, anisocytosis can resolve on its own as soon as the body adapts to the “new” blood and the diseased cells are replaced by healthy ones.

Symptoms of pathology

Since anisocytosis is almost always a sign of anemia, its symptoms are similar to those of this disease. Also, the clinical signs of this condition resemble those of heart failure. In any case, if you notice the signs described below, you should immediately consult a doctor and also do a general blood test:

• rapid fatigue;
• decline in performance;
• decreased concentration;
• inability to exercise;
• feeling of powerlessness, loss of strength;
• shortness of breath during exercise or for no reason, appearing from time to time;
• rapid heartbeat without connection with exercise;
• increased heart rate;
• pale skin;
• lack of pink color of the nail plates, their blanching;
• pallor of the eyeballs;
• headache;
• noise in ears;
• sleep and appetite disorders;
• decreased sex drive;
• skin sensitivity disorders.

A mild degree of anisocytosis can occur without symptoms, remaining unnoticed until it progresses, but sometimes goes away on its own. Although, in most cases, the condition that has arisen should be treated, which can be dangerous due to complications - fainting against the background of anemic hypoxia, the development of chronic heart failure, the appearance of heart murmurs.

Carrying out diagnostics

The main diagnostic method is a general blood test. It indicates all the main indicators of blood composition, and to identify anisocytosis, it is important to evaluate the indicators of platelets and red blood cells. The erythrocyte anisocytosis index is determined by a line called RDW-CV (red blood cell volume coefficient of variation) and RDW-SD (red blood cell volume mean deviation). The indicators reflect the area of ​​distribution of red blood cells in the total blood volume and their size. As for the study of platelets, the indicators MPV (mean platelet volume) as well as PDW (platelet anisocytosis indicator) are important for their study.

With megaloblastic anemia in humans, there is an increase in macrocytes in the overall composition of red blood cells. To fully diagnose anemia and differentiate its types, a peripheral blood smear is made, in which a final diagnosis is made based on the variation in the size of blood parameters, as well as the presence of other abnormalities (decrease in the number of reticulocytes, platelets, the appearance of Howell-Jolly bodies and many other malfunctions). To facilitate diagnosis, the doctor constructs a Price-Jones curve. In doubtful cases, the patient may be recommended to study the bone marrow, which is taken during the puncture. The level of vitamins and microelements in the blood is also often determined to clarify the nature of anemia and prescribe treatment.

Treatment methods

Treatment will depend entirely on the disease that caused the anisocytosis. For example, if you are taking medications that provoke a mega-regional condition, you should stop them or adjust the dose. The doctor will suggest that any patient immediately change their nutritional system and their diet, which should include foods rich in vitamins and minerals. Junk food, on the contrary, should be excluded from the diet so that the body does not waste energy on “extinguishing” its breakdown products. If there are no serious diseases, then a simple diet correction, a healthy lifestyle, and adequate sleep will help the patient get rid of anisocytosis. It is also very often recommended to take iron supplements and vitamin B12, which are in short supply in the body.

When oncology is the cause of anisocytosis, treatment cannot be left to chance; it should only be entrusted to professionals in a specialized center. Oncological diseases of the blood are now successfully treated with the help of operations, chemotherapy, radiation, the main thing is not to delay their implementation. If anisocytosis is caused by blood loss, for example, uterine bleeding, then the cause of the pathology should be addressed, for which the woman is prescribed various hormonal agents, antibiotics, and hemostatic drugs. Thus, treatment will be reduced to getting rid of the cause of the pathology, and after its elimination, the blood composition will return to normal on its own.

Features in children and pregnant women

Anisocytosis can occur even in an infant, as in children of any age. There is no need to panic right away, since children, even after suffering an infectious disease, can develop anemia, which, however, can be easily corrected by nutrition and taking vitamins. In infants, there is a complete change in the diameter of red blood cells, so anisocytosis in the first days of life usually does not pose a danger and goes away on its own.

During pregnancy, anisocytosis of erythrocytes is very common, because the consumption of all nutrients increases greatly, anemia becomes a common condition for many pregnant women. The most common is iron deficiency anemia, which reflects an acute lack of iron and should be corrected as early as possible. A pregnant woman should not only take vitamin complexes or special iron supplements, but also eat well. Anisocytosis can be detected when planning pregnancy. Thus, it becomes a contraindication for IVF, especially when combined with poikilocytosis (change in the shape of red blood cells), and the latter appears only in advanced forms of anemia. Even before conception, these pathologies should be eliminated so that the pregnancy develops correctly.

What not to do

If you have this disease, it is prohibited to lead an unhealthy lifestyle - smoking, drinking alcohol. All drugs should be taken with caution, because some of them can cause anisocytosis. You cannot ignore the consumption of meat and a large amount of vegetables and fruits, without which it will not be possible to restore the health of the body and normalize the composition of the blood.

Preventive measures

Measures to prevent anisocytosis are as follows:

• regular blood tests;
• balanced diet - consumption of meat, plant foods, nuts, legumes;
• treatment of all chronic diseases;
• elimination of foci of chronic infection;
• physical education, especially aerobic sports;
• rejection of bad habits;
• boosting immunity in different ways.