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Commentary 3.

The red cells have the characteristic appearance seen in heterozygous hereditary elliptocytosis. This is usually a benign condition, though there may be haemolysis in the neonatal period which subsides within the first year of life. Homozygotes or individuals that are doubly heterozygous for abnormalities of spectrin structure or spectrin production are likely to be severely anaemic, their red cells showing the marked fragmentation observed in hereditary pyropoikilocytosis.

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