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Images in Clinical Hematology
Open Access
Available online 17 July 2021
Mushroom-shaped red blood cells (pincer cells): a brief update
Guilherme Dienstmanna,
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Corresponding author at: Rua João Alexandre de França St., 349, CEP: 89225-140 Joinville, SC, Brazil.
, Vitor Barbosa dos Santosb, Samuel Ricardo Comarc
a Sociedade Educacional de Santa Catarina (UNISOCIESC), Joinville, SC, Brazil
b Laboratório Coser, Nova Venécia, ES, Brazil
c Universidade Federal do Paraná (UFPR) Curitiba, PR, Brazil
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Red cells with cytoplasmic projections, resembling pincer-like cells, also known as mushroom- shaped red blood cells, as Figures 1 and 2, are usually associated with erythrocyte disorders, such as congenital dyserthropoietic anemias, hereditary spherocytosis associated with Banda-3 protein deficiency, disseminated intravascular coagulation, hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura, kidney disease, microangiopathic hemolytic anemia, erythroleukemia and, more rarely, oxidative drug-induced hemolysis. However, a recent study have demonstrated a relationship between these cells and infection caused by Sars-CoV-2 in a pathophysiologic mechanism that possibly involves the occurrence of oxidative stress, which triggers progressive cascade of inflammation, known as citokines storm, that leads to red blood cell damage.1–3

Figure 1.

Pincer cells in a patient with chronic kidney disease and diagnosed with COVID-19.

Figure 2.

Pincer cells in a patient with chronic kidney disease and diagnosed with COVID-19.

D Gérard, S Ben Brahim, JF Lesesve, J Perrin.
Are mushroom-shaped erythrocytes an indicator of COVID-19?.
Br J Haematol, (2021), pp. 230
JF. Lesesve.
Mushroom-shaped red blood cells in protein band-3 deficiency.
Am J Hematol, 86 (2011), pp. 694
SR McCann, R Firth, N Murray, IJ. Temperley.
Congenital dyserythropoietic anaemia type II (HEMPAS): a family study.
J Clin Pathol, 33 (1980), pp. 1197-1201
Copyright © 2021. Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular
Hematology, Transfusion and Cell Therapy

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