Are you having problems with shortness of breath and rapid heart rate? You may have to go through an examination. It is because you may be a victim of Anisocytosis, a medical problem affecting the red blood cells (RBC).

If you ever had a concern about these symptoms, you came to the right place. Here, you will get to know more about the medical condition, the causes, symptoms, and treatment of anisocytosis.

Well, many of you are familiar with conditions such as anemia, sickle cells, etc. With such symptoms, the first thing that comes to your mind is the iron deficiency.

But, what you all are missing is the most important fact of all. All of the above- mentioned conditions have anisocytosis in common.

Hence, understanding anisocytosis is the key for you to determine if you or your loved ones may have any of these blood-related issues.

Now, let’s see the medical condition Anisocytosis in details.

Definition of Anisocytosis

Anisocytosis is a medical term meaning that a patient’s red blood cells are of unequal size. The size variability is due to abnormalities in the blood.

The definition is quite simple. But the underlying condition may be difficult to understand.

Moving on, let’s see what anisocytosis is.

What Is Anisocytosis?

Well now that you know the definition of anisocytosis, I’ll let you know what it is.

You see the name of the condition itself spells out what it is. Aniso means unequal, or dissimilar. Cytosis means “of cells.” The term anisocytosis is used to describe the size variation of red blood cells

The normal red blood cells (RBC) diameter is 7.2 µm, though it can vary from 6.8 to 7.5 µm. When RBCs size decreases more than 6.2 or exceeds 8.2 µm, the condition is termed as anisocytosis.

The shape and size of your red blood cells reflect on the transport of oxygen. When some become larger, the oxygen transport system is not efficient. When some misshapen, it becomes harder for the blood cells to disseminate oxygen.

Because of that, you start to suffer from many of the symptoms of anisocytosis.

To understand anisocytosis better the terms microcytic and macrocytic are used. The Microcytic condition is when the RBCs size becomes smaller than the normal range. While, the Macrocytic condition is when the RBCs size becomes larger than the normal range.

Types Anisocytosis

Anisocytosis is classified into 2 types- Type 1 & 2.

Type 1 & 2

+1 Anisocytosis –it means you have a low volume of irregular-sized cells. This shows that you have low iron or a form of anemia which has a low cell count, such as sickle cell anemia

+2 Anisocytosis – it means you have a high volume of irregular-sized cells. This shows that you have other types of vitamin deficiencies, hyperthyroidism, liver disease, or other conditions.

Causes Of Anisocytosis

I will now tell you a bit about the origin of the red blood cells or RBCs. The RBCs are formed in our bone marrow. The hormone erythropoietin secreted by our kidney helps in the production of RBCs, and it is further aided by maturation factors like vitamin B12, iron, and folic acid to mature the RBCs.

When this process is disturbed or over-influenced, anisocytosis develops. I’ll be listing down some of the most common causes down below.

i. Iron Deficiency

Iron is an important component for the RBCs. It forms the essential part in the production of RBCs. Deficiency of iron can lead to abnormal cell production.

ii. Inadequate Vitamin A

It is responsible for the body defense mechanism; inadequate intake of vitamin A causes lack of immunity. And ill physiological functioning leads to the incorrect production of blood cells and varied sized RBCs.

iii. Insufficient Vitamin B12

It is essential for RBCs maturation. Its insufficiency leads to poor absorption of essential nutrients. Thus, disruption of the normal cell division in the bone marrow occurs and leads to defective size, usually larger than the normal.

iv. Pernicious Anaemia

In this, the basic abnormality is in gastric mucosa. It fails to produce normal gastric secretions thus failing to produce intrinsic factors. In the absence of intrinsic factors, vitamin B12 is unable to function properly.

v. Liver disease

After the absorption of vitaminB12 by our body, it is stored in the liver. This is then slowly released by the bone marrow. If the liver damages, the storage, and discharge of vitamin B12 is also affected.

vi. Kidney disease

Kidney takes part in the production of RBCs. If it degenerates, then the whole process of RBC production is affected.

vii. Thalassemia

This is a congenital genetic disorder where the bonding of protein subunits, is hampered in hemoglobin. It leads to severe anemia and life-threatening condition.

viii. Malabsorption symptoms

If nutrients taken from our diet are not properly absorbed by the body, then this leads to lack of hemoglobin and causes the abnormal size of the RBCs.

ix. Blood transfusion

During transfusions, the difference in the size of the donor and recipient can lead to anisocytosis.

x. Diamond-Blackfan Anaemia

It is a type of anemia, where bone marrow is unable to produce sufficient amount of RBCs leading to the production of variable size of RBCs.

xi. Myelodysplastic Syndrome

The abnormalities of bone marrow lead to abnormal size variation in the RBCs.

Other disease factors which lead to anisocytosis like Sideroblastic anemia, burns, Lead poisoning, chronic anemic condition, etc.

Symptoms Of Anisocytosis

The vital function of RBCs is to transport oxygen and nutrients to different parts of the body. In general, the sizes of the RBCs are equal, and they efficiently hold and carry oxygen and nutrients.

In anisocytosis, the RBCs of unequal size and due to this reason the efficiency of RBCs is diminished. This affects the whole physiological system.

There are various symptoms that can provide warnings. Some of these may be mild but can gradually become severe. An individual with anisocytosis often feel the following symptoms

a. Shortness of breath

It is a common symptom. And is due to deficiency of hemoglobin, leading to lack of oxygen transportation. So, patients often feel shortness of breath after minimal activities.

b. Paleness

As the required oxygen isn’t reaching our skin, nails, and eyes, as it should; they become paler.

c. Lethargy

With the abnormality in the RBCs, oxygen distribution is inadequate. Hence, a general tiredness and fatigue is also a common symptom.

d. Tachycardia

Tachycardia or rapid heartbeat occurs not only after physical exhaustion but also in normal daily life. The heart is pumping rapidly to compensate the oxygen demand of the body, and so the heart beats become faster.

Other Symptoms

There can also be some other symptoms like a headache, low body temperature, coldness in palm and feet and vertigo ( a feeling of falling )

Diagnosis For Anisocytosis

The main way to diagnose anisocytosis is a blood sample. By observing the sample under a microscope, it can reveal if the cells have irregular shapes or non-uniform sizes.

From that initial look, more tests are performed to see the extent and nature of the issue.

The below-listed methods are the most common one.

i. Microscopic examination

It is essential to perform the blood smear test. Also known as the Blood Smear Test, it reveals the different sizes of the red blood cells

ii. RDW (Red Blood Cell Distribution Width)

This test is a part of the complete blood count (CBC) test. It is used to check the degree of anisocytosis. The high value of a variable size of the cells indicates anisocytosis.

This test confirms the type of anisocytosis, thereby confirming the diagnosis.

Since the anemic condition can be involved with other diseases; it is recommended that you take the following tests

• Anaemia test
• Thyroid function test
• Adrenal gland test
• Calcium deficiency

It is important for you to go through a thorough and detailed assessment, provide clear medical history and blood tests. This is needed to prevent misdiagnosis because there are other conditions that can mimic the changes encountered in anisocytosis.

Like in people who have an increased count of the white blood cells (WBCs) or abnormally large blood platelets.

Is Anisocytosis Common During Pregnancy?

Yes. The condition is common during the first half of the pregnancy. During this time, the fetus demands more iron. The average amount of iron intake is not adequate during pregnancy. This results in loss of iron in the women’s body resulting in a temporary Anisocytosis.

How To Get Rid Of Anisocytosis

Well as of now, there isn’t a particular cure. However, the treatments for Anisocytosis tend to vary since the causes of the disease vary from person to person. Anisocytosis is not a disease in itself.

Rather, it’s a symptom of some other condition in most cases. So, the treatment becomes difficult in most cases.

But then, early detection, finding the cause and proper treatment commencement is very important to restrict the complication. Often the treatment involves supplements, change in diet and blood transfusions.

1. Iron-deficiency anaemia

• Iron supplements
• Change in the diet to include more foods that are rich in iron (peas, dried fruits, spinach, lentils, dark green leafy veggies and prune juice)
• Vitamin C supplements – help with the absorption of the iron
• Blood transfusions – for severe cases
• Iron therapy IV – last alternative for severe cases and those who cannot take oral iron supplements

2. Vitamin A deficiency

• Vitamin A supplements
• Eating foods that are rich in vitamin A (liver, chicken, beef, eggs, carrots, mango, potatoes, leafy green veggies

3. Vitamin B12 deficiency

• Vitamin B12 supplements
• Eating foods that are rich in vitamin B12 (meat, poultry, seafood, dairy, eggs)

4. Diamond-Blackfan anaemia

• Corticosteroids
• Red blood cell transfusion
• Bone marrow transplant

5. Myelodysplastic syndrome

• Supportive therapy
• Blood cell transfusion
• Treatment of infections
• Bone marrow transplantation
• Cytotoxic chemotherapy

6. Sickle cell anemia

• Non-steroidal anti-inflammatory drugs
• Hydroxyurea
• Blood cell transfusion
• Antibiotics for the treatment of infections

7. Thalassemia

• Blood cell transfusion
• Iron chelators –it removes the excess iron in the body, accumulated through the regular blood transfusions

8. Chronic liver disease

• Symptomatic medication – morphine in more severe cases
• Supportive care
• Blood transfusions
• A liver transplant from the compatible donor.

Anisocytosis isn’t something serious to worry about and has no life risks. However, the condition causes physical discomfort and can be a sign of some more complicated disorders.

It is best to get medical treatment as early as possible. You should take action to make sure you know if it’s anisocytosis related.

• See a physician immediately
• Check your diet
• Follow your physician’s suggestions

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