This week’s Morphology Monday case features a patient with known Sickle Cell Disease (SCD) who presented with anaemia and signs of haemolysis. The full blood count showed a normocytic anaemia with a low haemoglobin level and a raised reticulocyte count, consistent with compensatory marrow response.
On the blood film, several classic features of SCD were noted:
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Marked red cell anisopoikilocytosis
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Numerous sickled red cells
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Polychromasia, indicating increased reticulocytes
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Nucleated red blood cells (NRBCs)
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Howell-Jolly bodies, suggestive of functional asplenia
These features are hallmarks of ongoing haemolysis and splenic dysfunction, commonly seen in patients with SCD. The presence of Howell-Jolly bodies reflects the spleen’s reduced filtering capacity, which is often due to autosplenectomy in chronic disease.
This case offered a striking visual display of sickling, red cell regeneration, and hyposplenism, key morphological indicators that support the diagnosis of Sickle Cell Disease.