Textbook of Hematology

Hooman H. Rashidi MD & John C. Nguyen MD

UCSD School of Medicine


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Title

Normal Red Blood Cells - An Overview

Authors

Hooman H. Rashidi MD, John Nguyen MD




[Maturation] [Microscopic features] [Increased production and Decreased Production (Anemia)] [Classic immunophenotype] [Pearls] [Pop Quiz]
[References]



Introduction

Normal mature RBCs are normocytic (MCV 80-100) and normochromic (1/3 central pallor). Its main function is to carry oxygen through its hemoglobin molecules.





Maturation

As erythroid precursors mature, the color of their cytoplasm changes from blue to gray to red-orange (this is due to the increase in the number of hemoglobin molecules within the red cells as they mature). Additionally, the nucleus of the red blood cell will become more dense as it matures, eventually excreting from the cell forming the mature RBC.





Microscopic features

Normal red blood cells range in size from 6-8 um, and are slightly smaller than a mature lymphocyte. In addition, red blood cells lacks a nucleus.

The cytoplasm is pink-orange in color with a central pallor that is 1/3 of its diameter.





Increased production and Decreased Production (Anemia)

Increased production: The amount of red blood cells in circulation can increase in a variety of conditions, including: reactive erythroid hyperplasia, post-erythropoietin therapy, and polycythemia vera. These entities are discussed later in this online textbook.

Decreased production of RBCs (Anemia) can be divided into three groups based on their size (MCV)

Note: For Decreased production of RBCs (AKA Anemias), see the Anemia image under the Textbook Table of Contents.




Classic immunophenotype

Red blood cells have the following immunophenotype:
- CD45-
- CD117-
- CD235a (Glycophorin A) +
- CD71-/+ (most mature RBCs are negative for transferrin receptor CD71)




Pearls

- A normocytic, normochromic red blood cell has central pallor that is 1/3 of its diameter
- The red blood cell undergoes a very distinct maturation pattern (mainly to increase hemoglobin concentration to be able to carry Oxygen)
- Anemia (decreased red blood cells) can be divided into three groups based on their size (MCV): see the anemia diagram for more details




Pop Quiz


What is the size of a normal RBC?



What is the diameter of the central pallor
of a normal RBC?





References

Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, and Vardiman JW (Eds.): WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues, IARC: Lyon 2008



 











   
Pearls:

- A normocytic, normochromic red blood cell has central pallor that is 1/3 of its diameter
- The red blood cell undergoes a very distinct maturation pattern (mainly to increase hemoglobin concentration to be able to carry Oxygen)
- Anemia (decreased red blood cells) can be divided into three groups based on their size (MCV): see the anemia diagram for more details














Content Editors/Website Administrators:
Hooman H. Rashidi, MD; John C. Nguyen, MD