4 Acanthocytes (Spur Cells)

Michelle To and Valentin Villatoro

Cell Description:

Red blood cells appear small and dense, lacking an area of central pallor with multiple spiky projections (spicules) of varying lengths protruding from the membrane. Projections are irregularly distributed around the cell membrane.1-3

Cell Formation:

Acanthocyte formation occurs as a result of either hereditary or acquired membrane defects. Defects that cause an imbalance between the membrane cholesterol and lipid content affect the RBC’s ability to deform resulting in more rigid plasma membrane. Red blood cells are then remodelled in circulation, resulting in an acanthocyte.1,3,4

Associated Disease/Clinical States:1-5

Abetalipoproteinemia (Inherited)

Lecithin-cholesterol acyltransferase (LCAT) Deficiency

Liver Disease


Pyruvate Kinase (PK) Deficiency


1. Cochran-Black D. Hemolytic anemia: membrane defects. In: Clinical laboratory hematology. 3rd ed. New Jersey: Pearson; 2015. p. 317-33.

2. Manchanda N. Anemias: red blood morphology and approach to diagnosis. In: Rodak’s hematology clinical applications and principles. 5th ed. St. Louis, Missouri: Saunders; 2015. p. 284-96.

3. Turgeon ML. Normal erythrocyte lifecycle and physiology.  In: Clinical hematology: theory and procedures. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1999. p. 71-98

4. Harmening D. The red blood cell: structure and function. In: Clinical hematology and fundamentals of hemostasis. 5th ed. Philadelphia: F.A. Davis Company; 2009. p. 759-792.

5. Rodak BF, Carr JH. Variations in shape and distribution of  erythrocytes. In: Clinical hematology atlas. 5th ed. St. Louis, Missouri: Elsevier Inc.; 2017. p. 93-106.


Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Acanthocytes (Spur Cells) Copyright © 2019 by Michelle To and Valentin Villatoro is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

Share This Book