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Q. What causes elliptocytes and ovalocytes in blood smear?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Aug 21, 2019

Hello doctor,

This is for my mother who I been concerned about. Would her reports seem acceptable for a smear slide examination? Anisocytosis 1+, ellliptocytes present, ovalocytes present. She developed memory and confusion issues within a month and has a heart valve issue with an ECG that was recorded at 36 bpm at one time.

Dr. Parth R Goswami

Hematology Pathology


Welcome to

Anisocytosis, eliptocytes all can be seen in anemia case. In iron deficiency anemia also it can be seen. So, you should check her hemoglobin level and HCT level. Do not worry about that. With the treatment of anemia, usually, it disappears.

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Thank you doctor,

Her results were:

WBC Count 5.6 10*3/uL 4.8 - 10.8 10*3/uL, RBC Count 4.45 10*6/uL 4.20 - 5.40 10*6/uL, HGB 14.4 g/dL 12.0 - 16.0 g/dL, HCT 41.7 % 37.0 - 47.0 %, MCV 93.8 fL 81.0 - 99.0 fL, MCH 32.5 pg 27.0 - 34.0 pg, MCHC 34.6 gm/dL 31.5 - 36.0 gm/dL, RDW 14.0 % 11.5 - 14.5 %, PLT 289 10*3 130 - 400 10*3, MPV 7.6 fL 7.4 - 10.4 fL, Neutrophils % 81.2 % %, Lymphocytes % 10.9 %, Monocytes % 7.0 %, Eosinophil % 0.3 %, Basophils % 0.6 %, Neutrophils Absolute 4.6 10*3/uL 1.8 - 8.0 10*3/uL, Lymphocytes Absolute 0.6 10*3/uL 1.0 - 4.0 10*3/uL, Monocytes Absolute 0.4 10*3/uL 0.0 - 1.0 10*3/uL, Eosinophils Absolute 0.0 10*3/uL 0.0 - 0.3 10*3/uL, Basophils Absolute 0.0 10*3/uL 0.0 - 0.1 10*3/uL.

Dr. Parth R Goswami

Hematology Pathology


Welcome back to

I read your mentioned report in question (attachment removed to protect patient identity). The hemoglobin level is within range. The hematocrit and red blood cells are also within range. So, your mother is not having anemia especially iron-deficiency anemia. Hence, do not worry about anisocytosis, adipocytes and ovalocytes. These all findings need not be given importance because CBC is normal especially Hb level. So do not worry about anisocytosis, adipocytes and ovalocytes. These all reflect mild variation in size and shape of red blood cells.

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