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Article
March 6, 1991

Intravascular Erythrophagocytosis

Author Affiliations

From the Department of Pathology, SUNY Health Science Center, Syracuse, NY.

From the Department of Pathology, SUNY Health Science Center, Syracuse, NY.

JAMA. 1991;265(9):1082. doi:10.1001/jama.1991.03460090030013
Abstract

A previously healthy 8-year-old boy developed severe hemolytic anemia several days after uneventful chickenpox. He presented shortly after cold exposure with a hematocrit of 0.12, hemoglobinuria, and a white blood cell count of 26 × 109/L. His presentation and laboratory findings strongly suggested postinfectious cold agglutinin disease of IgM type.1(pp526-527) The peripheral blood film at admission (Figure) was striking for erythrophagocytosis by 9% of 22 × 109/L segmented neutrophils, erythrocyte agglutination, and a rosette-like arrangement of erythrocytes about segmented neutrophils.

Intravascular erythrophagocytosis appears to serve as an auxiliary means of sequestering and destroying erythrocytes and occurs during excessive opsonization of intravascular erythrocytes1(pp98-101) and when splenic and hepatic macrophages are overwhelmed.2,3 Nonneoplastic diseases associated with intravascular erythrophagocytosis include two types of disorders: (1) those with an abundance of altered erythrocytes (as in sickle cell crisis4 and Heinz-body hemolytic anemia5,6) and (2) those

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