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Poikilocytes are abnormally shaped red blood cells. Normal red blood cells are round, flattened disks that are thinner in the middle than at the edges, whereas a poikilocyte is either a distortion of that normal shape or an entirely different shape. Generally, poikilocytosis can refer to an increase in abnormal red blood cells of any shape where they make up 10% or more of the total population.
If red cells show more than the normal degree of variation in red cell shape there is said to be poikilocytosis. Individual cells of abnormal shape are referred to as poikilocytes. Poikilocytosis can be graded as +, ++ or +++ (mild, moderate or severe). Individual cells of a particular shape have names that identify them.

Test results
Rather than being seen as a sign of any one disorder, poikilocytosis is a rather general condition. There may, however, be a predominance of one particular type of abnormally shaped red cells, some of which may indicate possible presence of a specific disorder or disease.
Abnormal red blood cells are seen in a wide range of conditions, so poikilocytosis is not specific. However, specific types of poikilocytes may be seen in particular disorder states and/or diseases.
In all cases, the treatment of poikilocytosis depends on its cause. For example, poikilocytosis can be caused by a vitamin deficiency (e.g. Vitamin B12 or folic acid), in which case the treatment is to replenish the deficient vitamin. It can be caused by a digestive disorder, such as celiac disorder, in which case the solution may lie in treating the underlying celiac disorder so that nutrients can be properly absorbed.

Definitions of cells by shape
Cell which is approximately spherical in shape so that it has lost its central pallor; the cell outline is regular
Spherocyte of reduced size and therefore diameter
Irregularly contracted cell
Cell of reduced size and diameter with a lack of central pallor but with an irregular outline
Cell with an elliptical outline
Cell with an oval outline
Teardrop poikilocyte
Cell shaped like a tear, less often known as a dacrocyte
Target cell
Cell with a more strongly staining area in the centre of the area of central pallor
Cell with a central slit or stoma
Cell with two or four curved horn-shaped projections
Schistocyte (red cell fragment)
Fragment of a cell, usually angular; a microspherocyte is a particular type of schistocyte
Echinocyte (crenated cell)
Cell with its surface covered with 20–30 small, regular, blunt projections
Cell with its surface covered with two to twenty projections of irregular shape and irregularly distributed
Sickle cell
Cell with a sickle or crescent shape, caused by the presence of a high concentration of an abnormal haemoglobin known as haemoglobin S
Boat-shaped cell
Cell similar in shape to an elliptocyte but with both ends being pointed, usually indicative of the presence of haemoglobin S
SC poikilocyte
Bizarre poikilocyte formed when cells contain both haemoglobin S and haemoglobin C, having some curved edges and some square or rectangular protrusions

All information on this page is intended for your general knowledge only and does not provide medical advice, diagnosis or treatment.