Peripheral smear in microangiopathic hemolytic anemia showing presence of schistocytes

Peripheral blood smear from a patient with a microangiopathic hemolytic anemia with marked red cell fragmentation. The smear shows multiple helmet cells (arrows) and other fragmented red cells (small arrowhead); microspherocytes are also seen (large arrowheads). The platelet number is reduced; the large platelet in the center (dashed arrow) suggests that the thrombocytopenia is due to enhanced destruction.

High-power view of a normal peripheral blood smear. Several platelets (arrowheads) and a normal lymphocyte (arrow) can also be seen. The red cells are of relatively uniform size and shape. The diameter of the normal red cell should approximate that of the nucleus of the small lymphocyte; central pallor (dashed arrow) should equal one-third of its diameter.