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The “Burr” Red Cell and Azotaemia

1957; BMJ; Volume: 10; Issue: 3 Linguagem: Inglês

10.1136/jcp.10.3.252

1472-4146

Wynne Aherne,

Hemoglobinopathies and Related Disorders

(RECEIVEDFOR PUBLICATIONSEPTEMBER3,1956) In1949Schwartz andMottodescribed a new poikilocyte whichtheytermed aburrcell. They characterized itasapeculiar redcell, measuring about7.5, orless indiameter, andhaving oneor morelarge spiny projections alongitsperiphery. Theyfounditmostoften inazotaemia (55of75 cases inwhichthenon-protein nitrogen exceeded 70mg.%),andoccasionally ingastric carcinoma and bleeding peptic ulcer. Theyconcluded thatthere wasnocorrelation between theoccurrence ofburr cells andthelevel ofanaemia ornitrogen retention. Dacie(1954), ontheotherhand,describes an essentially similar redcell deformity instates of rapidly progressive renal failure, andcontends that itsappearance isaccompanied, atleast insome cases, byahaemolytic anaemia. Itwouldappear that, apart fromthese observations, little attention hasbeengiven tothis relatively commonhaematological finding. An attempt was therefore madetoassess itssignificance inclinical haematology, withparticular reference tostates of nitrogen retention. Methods Haemoglobin was estimated as oxyhaemoglobin, using theM.R.C.Grey-wedge photometer (Macfarlane, King,Wootton, andGilchrist, 1948).Reticulocyte preparations weremadebythemethodofDacie(1950) andcountedbymeansoftheMiller ocular disc (Schneiderman andBrecher, 1950).Platelets were counted bythemethod ofBrecher andCronkite (1950). Redcell osmotic fragility wastested byamodification ofthemethodofDacieandVaughan (1938). Standard procedure wasusedfortheCoombsantiglobulin test. Bloodfilms weremadedirectly fromfinger-prick or venousbloodon carefully cleaned slides andstained withMay-Griinwald-Giemsa.