Significance of Schistocytes in Clinical Practice

Clinical Significance and Interpretation

• The presence of schistocytes >1% is a robust cytomorphological threshold that favors a diagnosis of TMA, but absence of schistocytes should not exclude an earlier diagnosis of TMA due to the test's low sensitivity 1
• For TTP/HUS diagnosis, schistocytes should be evaluated alongside other criteria including thrombocytopenia, microangiopathic hemolytic anemia, elevated LDH levels, and reduced haptoglobin levels 1

Conditions Associated with Elevated Schistocytes

• Thrombotic microangiopathies (TTP/HUS) can be associated with schistocytes ≥1% 1

Laboratory Considerations

• False thrombocytopenia should be excluded by examining the peripheral blood smear before initiating investigations for true thrombocytopenia 2