Wednesday, November 28, 2007


A 50 year old homeless man presents to the ER with slurred speech, nystagmus, and unsteady gait. There is no history of head trauma. His blood smear is above with the abnormal cell marked by the arrow. This is not a hereditary or genetic condition.

Challenge: What is the cause of this finding?

Related Questions:
1. What is the blood smear finding called?

Image shown under fair use.

1 comment:

Craig said...


The blood smear shows a stomatocyte, an erythrocyte with a mouth-shaped area of central pallor. This also involves a decrease in ratio of surface area to volume usually due to change in permeability, leading to increased volume. Thus, these cells may be trapped in the spleen and hemolyzed. Acquired causes of stomatocytosis include acute alcohol intoxication and chronic alcoholic liver disease. Here, the history suggests acute alcohol intoxication.

Sources: UpToDate, Marist College.