A burr cell, also known as an echinocyte or crenated cell, is an abnormally shaped red blood cell. Its characteristic feature is the presence of numerous small, evenly spaced, short projections, called spicules, extending from its cell membrane. These spicules give the cell its distinctive, spiky appearance.
Characteristics of Burr Cells
- Shape: Round or slightly oval with numerous short, blunt projections (spicules).
- Number of Spicules: Typically 10-30 spicules evenly distributed across the cell's surface.
- Spicule Size and Distribution: Spicules are uniform in size and spacing.
- Central Pallor: The central pallor (lighter area) of the red blood cell is usually retained.
- Reversibility: In many cases, the changes leading to burr cell formation are reversible, meaning that the cell can return to its normal shape if the underlying cause is addressed.
Causes of Burr Cell Formation
The appearance of burr cells in a blood sample can indicate several underlying health conditions. These include:
- End-stage kidney disease: Uremia (high levels of nitrogenous waste products in the blood) is a common cause.
- Liver disease: Liver dysfunction can contribute to the formation of burr cells.
- Blood group abnormalities: Certain irregularities in blood group composition can be associated with burr cells.
- High levels of nitrogenous waste in the blood (uremia): As mentioned above, this is a significant factor in kidney disease.
- Parenteral fish oil administration: In rare cases, intravenous fish oil administration, particularly in infants with short bowel syndrome, has been associated with burr cell anemia.
- Artifact: In some instances, burr cells may be an artifact of the blood smear preparation process, rather than a true reflection of a medical condition.
Significance of Burr Cells
The presence of burr cells in a blood test warrants further investigation to determine the underlying cause. It highlights the need for a comprehensive medical assessment to diagnose and manage potential health issues affecting the kidneys, liver, or blood.
