Heinz bodies.[4] Bite cells can contain more than one "bite." The "bites" in degmacytes are smaller than the missing red blood cell fragments seen in schistocytes.[citation needed
]
BITE CELLS
Degmacytes usually appear smaller, denser, and more contracted than a normal red blood cell due to the bites.[5] The appearance of the "bites" in red blood cells may vary in number, smoothness, and size.[5] These cells can also exhibit other peripheral effects.[2]
Blister cell
In
blister cells, an outer rim of cytoplasm is maintained, and when this ruptures, the resulting bite cells have horn-like projections. Blister cells appear as red blood cells containing a peripherally located vacuole.[6]
Causes
Bite cells are caused by G6PD deficiency, NADPH deficiency, thalassemia,
pentose phosphate shunt, oxidative drugs and unstable hemoglobins.[6] People receiving large quantities of oxidative drugs such as dapsone or sulfasalazine are more prone to have degmacytes.[1] The underlying cause of degmacytes is a result of the splenic macrophages removing Heinz bodies from the membrane of red blood cells, which results in a "bitten" appearance of the cell. [7][8][9]
Diagnosis
The diagnosis of degmacytes is performed by using a
peripheral blood smear to analyze the red blood cells in the blood. The degmacyte look similar to a "bitten apple", which is their defining feature. However, bite cells may be difficult to distinguish from helmet cells, a fragmented red blood cell, due to the similarity in shape.[6] Confirming the presence of degmacytes in patients likely indicates a form of red blood cell oxidant injury or hemolysis.[10]
Treatment and Prevention
Bite cells are primarily formed due to a
hypoxia, which can then lead to hemolytic disorders. If one is not G6PD deficient, lessening the use of oxidative triggers may help prevent the formation of degmacytes.[2]
As there are currently no means of reversing red blood cell damage and the formation of degmacytes, treatment options are limited to
