What is the effect of schistocytes on MCV and RDW in thalassemia?

In thalassemia, schistocytes, which are fragmented red blood cells, contribute to the overall interpretation of red blood cell indices such as Mean Corpuscular Volume (MCV) and Red Cell Distribution Width (RDW). Schistocytes typically indicate hemolysis or microangiopathic processes, conditions where red blood cells are damaged as they pass through small or obstructed vessels.

The presence of schistocytes can lead to an increased RDW because these fragmented cells will vary in size compared to the more normal erythrocytes in circulation. RDW is a measure of the variation in red blood cell size; having a greater mix of both normal-sized cells and smaller, fragmented cells raises the overall width of the distribution.

Regarding MCV, schistocytes can lead to variability in the average size of the red blood cells measured. While thalassemia primarily involves microcytic anemia (characterized by smaller-than-normal red blood cells), the introduction of schistocytes can result in a range of cell sizes that may influence the MCV readings. Essentially, the MCV may not change uniformly but could show a variable result due to the mixture of differently sized cells.

Thus, the effect of schistocytes in thalassemia