Abnormalities or spotting in the blood cells is known as basophilic stippling. This can be associated as a symptom, to a number of blood disorders and diseases. In this article, we will look at the various causes of this condition.
Did You Know?
The average lifespan of a red blood cell ranges from 100 – 120 days. As such, around 1% of the red blood cells in the human body get replaced everyday. However, blood disorders can affect this rate adversely, leading to stippling of the cells.
What is Basophilic Stippling?
Basophilic stippling, also known as Punctuate basophilia, can be defined as distinct or diffuse, fine to coarse, dark granular patterns in the erythrocytes, representing aggregated ribosomes and caused by ineffective heme formation. It is a condition observed in the erythrocytes (red blood cells) while examining blood smears under a microscope, where the cells display small dots at the periphery. These dots display the abnormal collection of nucleic acid/ribosomes of the cells, which can be an indicator of a disease. However, it can sometimes be found even in normal individuals.
Basophilic refers to any cells that are stained with a dye, and stippling refers to any object which is covered in dots. This phenomenon can only be observed if the blood smear had been stained with a special alkaline dye, which reacts to molecules in the cell which are negatively charged, resulting in coloration. Such staining makes stippling easy to see when magnified under a laboratory grade microscope. Let us now look at the common causes of basophilic stippling in the blood.
Causes of Basophilic Stippling
Clumping of Nucleic Material: Basophilic stippling occurs when the nucleic acid in a cell is not in the normal position. The colored spots show the places where RNA and mitochondria clump together, forming large coarse spots. On the other hand, precipitation of ribosomes causes small and fine stippling. In healthy cells, there is no clumping, hence, they appear smooth without any spots.
Blood Poisoning: Lead poisoning is one of the most commonly associated causes of basophilic stippling of RBCs. In this case, the stippling occurs because the nucleotidase enzyme used for the breakdown of RNA is affected by the lead contamination on the bone marrow. The spotting can be seen in both, young and old blood cells. Alternatively, microbial infections can also lead to blood poisoning, which can lead to stippling.
Lack of Oxygen: When oxygen levels in the environment are low, or when the blood cells are unable to absorb oxygen properly, the body reacts by disordered and increased production of red blood cells. These new blood cells usually have immature cytoplasm, which usually have clumped nucleic material, leading to basophilic stippling.
Anemia: This disease shows the decrease in the number of red blood cells, and the amount of hemoglobin in the blood. Along with an increase in the distance between the blood cells, and other abnormalities, basophilic stippling can also be a symptom of various types of anemia. The spotting can be seen mostly in the young blood cells.
Thalassemia: This disease is a type of blood disorder which is characterized by abnormal formation of hemoglobin due to the lack of alpha globin genes or beta globin genes. This often results in microcytosis (reduction in the size of blood cells), which can lead to basophilic stippling. This can occur in both, thalassemia major as well as thalassemia minor. Basophilic stippling is also used as an indicator to distinguish between thalassemia and iron deficiency, where the stippling is more prominent in the former.
Other Causes: The usage of certain drugs/medications, deficiencies of various vitamins, allergies, exposure to radiation, and 2nd or 3rd degree burns have also been known to cause the basophilic stippling of red blood cells in adults.
Although it is an important part of diagnosing many blood disorders and diseases, it is not all-conclusive. Laboratories have to perform a number of other tests and look for many other symptoms to reach a definitive result.