What are Burr Cells? - Causes & Significance

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  • 0:00 What Are Burr Cells?
  • 1:06 Causes: Artificial
  • 2:24 Cause: Disorder
  • 3:54 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

What do sea urchins and red blood cells have to do with one another? You'll find this out and more in this lesson on burr cells, their causes, and their significance.

What Are Burr Cells?

Have you ever seen a sea urchin? Those sea animals that are quite round but have a bunch of spikes sticking out on them? Try not to step on one, as the result can be excruciatingly painful!

Burr cells are red blood cells that have short and evenly-spaced spikes all over their surface, like sea urchins. More specifically, these cells have around 10 to 30 uniform spikes, called spicules, that are evenly distributed over the red blood cell's surface. It's believed that these spicules form as the outer portion of the red blood cell's lipid bilayer expands outwards relative to the inner portion of the bilayer.

A burr cell might be a bit smaller than a normal red blood cell and might have what's known as central pallor, or a centrally pale region. The morphological changes associated with burr cells may be reversible under some circumstances.

Burr cells are also called:

  • Echinocytes, which means sea urchin cells and is a commonly used synonym.
  • Berry cells (not commonly used)

Causes: Artificial

The presence of burr cells is often indicative of nothing more than an artifact, something created artificially, and is thus of no diagnostic or clinical significance.

For example, red blood cells interacting with the glass of a microscope slide during a stained blood smear might result in the formation of burr cells. The basic substances released by a glass slide may raise the pH of the smear, which results in echinocyte formation in vitro. In vitro is Latin for ''within the glass'' and refers to samples taken outside of a living organism and placed in an artificial environment. As a result, it would be important to compare such a slide with a wet preparation of blood and observe the unstained red blood cells in vivo, Latin for ''within the living,'' to see if this was indeed an artifact or not.

Another possible formation of echinocytes occurs in blood transfusion patients. Red blood cells stored at 4 degrees Celsius will turn into echinocytes within a few days. However, within a few minutes inside of a person's body, the echinocytes will transform into normally-shaped red blood cells thanks to the plasma's buffering action. So if a blood sample is taken immediately after the transfusion, echinocytes will be seen. After a few minutes, though, they won't be.

Cause: Disorder

Of course, burr cells aren't always artifactual in nature. There are numerous disorders that might lead to their appearance. These include the following, and possible combinations thereof:

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