What is the Difference Between Acanthocytes and Echinocytes

The main difference between acanthocytes and echinocytes is that acanthocytes have small regular projections, whereas echinocytes have larger, irregular projections.  

Acanthocytes and echinocytes are two forms of red blood cells with abnormal cell walls. Many small, evenly spaced thorny projections are the main characteristic feature of these cells. Also, acanthocytes occur in liver disease, while echinocytes occur in renal disease.

Key Areas Covered

1. What are Acanthocytes
– Definition, Facts, Occurrence
2. What are Echinocytes
– Definition, Facts, Occurrence
3. Similarities Between Acanthocytes and Echinocytes
– Outline of Common Features
4. Difference Between Acanthocytes and Echinocytes
– Comparison of Key Differences

Key Terms 

Acanthocytes, Burr Cells, Echinocytes, Spur Cells

What are Acanthocytes

Acanthocytes or spur cells are a phenotype of red blood cells. They contain spiculation of red blood cells and a few projections of varying sizes. They resemble many pointed stars with coarse, irregularly spaced, variably sized crenations in blood films of liver disease, abetalipoproteinemia, McLeod syndrome, chorea acanthocytosis, and other disorders like anorexia nervosa, hypothyroidism, neuroacanthocytosis, infantile pyknocytosis, alcoholism, idiopathic neonatal hepatitis, Zieve syndrome, congestive splenomegaly, and chronic granulomatous disease.

Figure 1: Acanthocytes

Furthermore, spur cells refer to a subset of extreme acanthocytes in which splenic modifications occur. For example, additional cell membrane loss can blunt the spicules, and the acanthocytes become spherocytic, as seen in patients with severe liver disease. However, acanthocytes are red blood cells with crenation that occur in pancreatitis and severe cirrhosis. On the other hand, abetalipoproteinemia is a clinical condition that has acantholytic red blood cells.

What are Echinocytes 

Echinocytes or burr cells are other phenotypes of red blood cells. They have abnormal cell membranes with characteristic many small evenly-spaced thorny projections. In comparison to acanthocytes, the projections of echinocytes are smaller and more numerous, and evenly spaced. Also, a central pallor occurs in echinocytes stained under Wright staining in light color in the center of the cell. Importantly, pinocytosis is a reversible condition of red blood cells.

Figure 2: Echinocytes

Echinocytes occur in several disease conditions, including chronic kidney disease, uremia, pyruvate kinase deficiency, hypophosphatemia, hyperlipidemia, phosphoglycerate kinase deficiency, disseminated malignancy, myeloproliferative disorders, vitamin A deficiency, early posttransfusion of red blood cells. 

Similarities Between Acanthocytes and Echinocytes

• Acanthocytes and echinocytes are two forms of red blood cells that occur in disease conditions.
• They contain small, evenly-spaced thorny projections. 

Difference Between Acanthocytes and Echinocytes

Definition

Acanthocytes refer to spiculated red cells with a few projections of varying size and surface distribution. In contrast, echinocytes refer to spiculated RBCs in which the spicules are relatively evenly spaced and of similar size. 

Other Names

Another name for acanthocytes is spur cells, while another name for echinocytes is burr cells. 

Morphology

Acanthocytes contain larger, irregular projections, while echinocytes contain small, regular projections. 

Disease Conditions

Acanthocytes occur in liver disease, abetalipoproteinemia, McLeod syndrome, chorea acanthocytosis, and other disorders like anorexia nervosa, hypothyroidism, neuroacanthocytosis, infantile pyknocytosis, alcoholism, idiopathic neonatal hepatitis, Zieve syndrome, congestive splenomegaly, and chronic granulomatous disease. In contrast, echinocytes occur in chronic kidney disease, uremia, pyruvate kinase deficiency, hypophosphatemia, hyperlipidemia, phosphoglycerate kinase deficiency, disseminated malignancy, myeloproliferative disorders, vitamin A deficiency, early posttransfusion of red blood cells. 

Conclusion

In brief, acanthocytes and echinocytes are two forms of red blood cells that occur in disease conditions. Acanthocytes are also known as spur cells. They contain large, irregular projections. They are seen in liver disease. In comparison, echinocytes are also known as burr cells. They have small, regular projections. They occur in renal disease. Therefore, the main difference between acanthocytes and echinocytes is their morphology.   

References:

1. Acanthocyte. Acanthocyte – an overview | ScienceDirect Topics. (n.d.). 
2. Echinocyte. Echinocyte – an overview | ScienceDirect Topics. (n.d.). 

Image Courtesy:

1. “Acanthocytes, Peripheral Blood (3884092551)” By Ed Uthman from Houston, TX, USA– Own work (CC-BY 2.0) via Commons Wikimedia
2. “Poikilocytes – Red blood cell types” By Ed Uthman, S Bhimji and Mikael Häggström – Own Work (CC-BY 4.0) via Commons Wikimedia