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Stomatocytosis and anemia developing with hypophosphatemia: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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[Stomatocytosis
Stomatocytosis is a rare state of erythrocytes, in which the central zone of the erythrocyte has the form of a "mouth" or "slot". These cells are associated with congenital or acquired hemolytic anemia. Symptoms of the disease are caused by anemia.
Rarely occurring hereditary dentocytosis has an autosomal dominant type of inheritance and manifests itself at an early age. The erythrocyte membrane has an increased permeability for monovalent cations (Na and K), while for divalent cations and anions it remains normal. About 20-30% of circulating red blood cells are dentites. The fragility of erythrocytes is increased, as is the test of autohemolysis with unstable correction of glucose. In some cases, splenectomy reduces the severity of anemia.
Acquired dentocytosis with hemolytic anemia occur mainly when taking alcohol in large doses. Stomatocytosis in the blood and hemolysis disappear within 2 weeks after stopping drinking alcohol.
Anemia due to hypophosphataemia
The plasticity of the erythrocyte varies according to the level of intracellular ATP. Since the concentration of serum phosphates affects the level of erythrocyte ATP, at a concentration of less than 0.5 mg / dl (<0.16 mmol / l), the level of erythrocyte ATP decreases. The complex of metabolic consequences of hypophosphatemia also includes depletion of 2,3-diphosphoglyceric acid, shift of the dissociation curve 0 2 to the left, reduction of glucose utilization and increase in lactate production. As a result, rigid, inelastic red blood cells become sensitive to damage in the capillary bed, which leads to the development of hemolysis, small size and spherical form of erythrocytes (microspherocytosis).
Pronounced hypophosphatemia can occur with a sharp discontinuation of alcohol intake, diabetes mellitus, excessive feeding after prolonged fasting, a recovery (diuretic) phase after severe burns, overeating, severe respiratory alkalosis and in patients with uremia who are on dialysis and taking antacids. The addition of phosphates prevents or reverses anemia and indicates a contingent of patients with hypophosphatemia or the risk of developing it.