Abstract
Background: Dacrocytes or “teardrop cells” are elongated red blood cells at one end forming a cell with the appearance of a tear drop and are of varying size. Dacrocytes are frequently observed in complete blood counts of patients with myeloproliferative disease, but can also be found in other systemic diseases in which their prevalence and clinical significance remains unknown. Objective: To evaluate the prevalence and possible clinical significance of dacrocytes observed in the peripheral blood smear of patients with different systemic diseases. Methods: This is a descriptive study that analyzed the peripheral blood smears of 35,086 patients in a tertiary care hospital, in search of dacrocytes, and correlating this finding with their clinical and biochemical profiles. Results: Dacrocytes were intentionally sought in 35,086 peripheral blood smears. The observed prevalence of dacrocytosis was 1.4% (n=492 patients). No statistically significant relationship was established between dacrocytosis and the patients’ diagnoses, although there was a tendency to find dacrocytes in patients with cancer (CA) and systemic lupus erythematosus (SLE). Thus the presence of dacrocytes was not associated to the type of anemia or to the degree of renal dysfunction. Our results do not support the theory asserting that dacrocyte formation is a result of splenomegaly since only 28.5% of patients with this erythrocyte anomaly presented associated splenomegaly. Conclusion: Dacrocytosis may be present, at a very low prevalence, in various systemic diseases. It is independent of the type of anemia and the degree of renal dysfunction. For the first time, splenomegaly is excluded as the only cause of dacrocytosis in peripheral blood smears.
Highlights
Dacrocytes or “teardrop cells” are elongated red blood cells at one end forming a cell with the appearance of a teardrop and are of varying size [1] (Figure 1).These cells are most frequently observed in peripheral blood smears of patients with primary or secondary myelofibrosis with myeloid metaplasia, different types of anemia including iron deficiency, hemolytic, and megaloblastic anemia, as well as infiltrative disorders of the bone marrow such as leukaemia, lymphoma or metastatic solid neoplasms [2,3,4]
The aim of this study was to determine the relationship between the prevalence of dacrocytosis and systemic diseases, and to correlate the presence of these teardrop cells with different types of anemia, renal dysfunction and splenomegaly in a tertiary care hospital
By analyzing the patients’ diseases (n=492), we observed that the most frequent diagnoses encompassed all forms of cancer in 103 (20.9%), followed by systemic lupus erythematosus (SLE) in 97 (19.7%), liver cirrhosis in 75 (15.2%) and type 1 and 2 diabetes mellitus (DM) in 37 (7.5%) patients
Summary
Dacrocytes or “teardrop cells” are elongated red blood cells at one end forming a cell with the appearance of a teardrop and are of varying size [1] (Figure 1). These cells are most frequently observed in peripheral blood smears of patients with primary or secondary myelofibrosis with myeloid metaplasia, different types of anemia including iron deficiency, hemolytic, and megaloblastic anemia, as well as infiltrative disorders of the bone marrow such as leukaemia, lymphoma or metastatic solid neoplasms [2,3,4]. The aim of this study was to determine the relationship between the prevalence of dacrocytosis and systemic diseases, and to correlate the presence of these teardrop cells with different types of anemia, renal dysfunction and splenomegaly in a tertiary care hospital. Dacrocytes are frequently observed in complete blood counts of patients with myeloproliferative disease, but can be found in other systemic diseases in which their prevalence and clinical significance remains unknown
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