also see Normal values, CBC, Anemia in the newborn, Anemia, physiologic

I. Microcytic, Hypochromic – due to impairment of synthesis of heme or globin

II. Normochromic, Normocytic:

III. Macrocytic:

Clues as to etiology of anemia when cell shape is abnormal:


Possible diagnosis


vitamin E deficiency, liver disease

Bizarre shapes

RBC membrane defects, thalassemia syndromes

Blister or bite cells

G6PD deficiency

Helmet cells(fragmented cells)

microangiopathic anemia

Rouleaux (stacking of RBCs)

Inflammation or immune hemolytic anemia


liver disease, stomatocytosis

Target cells

iron def., hemoglobinopathy, liver disease

Tear-drop cells

bone marrow failure, burns

from CHLA Board Review 2005