Schistocytes on a blood smear indicate which condition?

• A. Disseminated Intravascular Coagulation (DIC)
• B. Iron Deficiency Anemia
• C. Aplastic Anemia
• D. Polycythemia

Answer: (A)

Schistocytes are fragmented red blood cells formed when circulating RBCs are sheared as they pass through damaged microvasculature. This pattern signals intravascular hemolysis from a microangiopathic process, most commonly seen with disseminated intravascular coagulation, where widespread clotting leads to the formation of microthrombi that shear red cells.

Iron deficiency anemia typically shows small, pale red cells (microcytosis) and does not produce lots of fragmented cells. Aplastic anemia presents with pancytopenia and a hypocellular marrow rather than fragmented RBCs on the smear. Polycythemia indicates an increased red cell mass rather than evidence of intravascular destruction.

So the presence of schistocytes most aligns with disseminated intravascular coagulation.