Stomatocytes (RBCs with slit-like central pallor)

Stomatocytosis is a rare condition of RBCs in which a mouthlike or slitlike pattern replaces the normal central zone of pallor.

These cells are associated with congenital and acquired hemolytic anemia. The symptoms result from the anemia.

The rare congenital stomatocytosis, which shows autosomal dominant inheritance, causes a severe hemolytic anemia presenting very early in life.

The RBC membrane is hyperpermeable to monovalent cations (Na and K); movement of divalent cations and anions is normal.

About 20 to 30% of circulating RBCs are stomatocytic; RBC fragility is increased, as is autohemolysis with inconstant correction with glucose.

Splenectomy ameliorates anemia in some cases.

Acquired stomatocytosis with hemolytic anemia occurs primarily with recent excessive alcohol ingestion. Stomatocytes in the peripheral blood and hemolysis disappear within 2 wk of alcohol withdrawal.

Stomatocytosis could also seen in thalassemia and liver disease.

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