Omar Adwan: Understanding Clinical Significance and Diagnostic Implications of Acanthocytes
Omar Adwan, Medical Laboratory Technologist at Modawah Lab Center, shared a post on LinkedIn:
“Acanthocyte
Red Blood Cells with spiky projections of varying size, length, and distribution, giving it an irregular shape.
This differs from echinocyte, which has short, evenly spaced projections around the cell surface.
Conditions commonly associated with Acanthocytes
- Severe liver disease / Spur-cell anemia
Seen in advanced cirrhosis, where plasma lipid alterations lead to acanthocyte formation and severe hemolytic anemia.
- Abetalipoproteinemia (hereditary)
A genetic lipid disorder caused by defective MTP, leading to absence of apolipoprotein-B–containing lipoproteins, acanthocytosis, and fat-soluble vitamin deficiencies (e.g., vitamin E) with neurological manifestations.
- Neuroacanthocytosis syndromes
A group of neurological disorders associated with acanthocytosis, such as chorea- acanthocytosis (VPS13A) and McLeod syndrome (XK gene), often presenting with chorea, dystonia, neuropathy, etc.
- Others:
Post- splenectomy, malnutrition/anorexia, certain renal or metabolic disorders (clinical relevance varies).
Clinical significance
- Numerous acanthocytes – suggest severe disease, especially spur-cell anemia due to cirrhosis.
- Neurological symptoms – consider neuroacanthocytosis.
- Children with malabsorption – consider abetalipoproteinemia.”

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