Prevalence of Dacrocytosis in Patients with Chronic Diseases: Splenomegaly is not Mandatory for Teardrop Cells Genesis Rojas-Maya S 1 , Sarias-Cueto LA 1 , Perez-Diaz I 2* , Osorio-Landa HK 3 , Garcia-Martinez B 4 , Fagundo-Sierra R 1 , Rivera-Moscoso R 2 , Carrillo-Maravilla E 2 and Laguna-Barcenas SC 5 1 Biological and Pharmaceutical Chemistry Central Laboratory, National Institute of Medical Science and Nutrition Salvador Zubiran, Tlalpan, Mexico 2 Medicine Department, National Institute of Medical Science and Nutrition Salvador Zubiran, Tlalpan, Mexico 3 School of Medicine, Monterrey Institute of Technology and Higher Education, Mexico 4 Biological and Pharmaceutical Chemistry, Metropolitan University, Mexico 5 Autonomous University of Queretaro, Queretaro, Mexico * Corresponding author: Perez-Diaz I, PhD, MD, Medicine Department, National Institute of Medical Science and Nutrition Salvador Zubiran, Tlalpan, Mexico, Tel: + +52-54 87 09 00; E-mail: ivan.endocrino@gmail.com Received date: March 10, 2016; Accepted date: April 13, 2016; Published date: April 20, 2016 Copyright: © 2016 Rojas-Maya S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Dacrocytes or “teardrop cells” are elongated red blood cells at one end forming a cell with the appearance of a tear drop and are of varying size. Dacrocytes are frequently observed in complete blood counts of patients with myeloproliferative disease, but can also be found in other systemic diseases in which their prevalence and clinical significance remains unknown. Objective: To evaluate the prevalence and possible clinical significance of dacrocytes observed in the peripheral blood smear of patients with different systemic diseases. Methods: This is a descriptive study that analyzed the peripheral blood smears of 35,086 patients in a tertiary care hospital, in search of dacrocytes, and correlating this finding with their clinical and biochemical profiles. Results: Dacrocytes were intentionally sought in 35,086 peripheral blood smears. The observed prevalence of dacrocytosis was 1.4% (n=492 patients). No statistically significant relationship was established between dacrocytosis and the patients’ diagnoses, although there was a tendency to find dacrocytes in patients with cancer (CA) and systemic lupus erythematosus (SLE). Thus the presence of dacrocytes was not associated to the type of anemia or to the degree of renal dysfunction. Our results do not support the theory asserting that dacrocyte formation is a result of splenomegaly since only 28.5% of patients with this erythrocyte anomaly presented associated splenomegaly. Conclusion: Dacrocytosis may be present, at a very low prevalence, in various systemic diseases. It is independent of the type of anemia and the degree of renal dysfunction. For the first time, splenomegaly is excluded as the only cause of dacrocytosis in peripheral blood smears. Keywords: Dacrocyte; Systemic disease; Anemia; Renal dysfunction; Splenomegaly Introduction Dacrocytes or “teardrop cells” are elongated red blood cells at one end forming a cell with the appearance of a teardrop and are of varying size [1] (Figure 1). Tese cells are most frequently observed in peripheral blood smears of patients with primary or secondary myelofbrosis with myeloid metaplasia, diferent types of anemia including iron defciency, hemolytic, and megaloblastic anemia, as well as infltrative disorders of the bone marrow such as leukaemia, lymphoma or metastatic solid neoplasms [2-4]. Furthermore, isolated reports have identifed dacrocytes in patients with various systemic diseases associated to chronic renal dysfunction. However, information on the clinical implications of dacrocytosis in these systemic diseases has been practically non-existent and no study has evaluated its relationship with the presence of anemia and renal dysfunction. Whether the dacrocytosis in these patients is a result of concomitant splenomegaly, as it is believed nowadays, also remains unknown. Te aim of this study was to determine the relationship between the prevalence of dacrocytosis and systemic diseases, and to correlate the presence of these teardrop cells with diferent types of anemia, renal dysfunction and splenomegaly in a tertiary care hospital. Materials and Methods Tis is a descriptive research study. Dacrocytes were sought in 35,086 peripheral blood smears of in-patients at a tertiary care hospital. Smears were obtained from the Hematology Laboratory between August and October 2013. Te smears with identifed dacrocytes were classifed according to O’Connor’s criteria [5], as normal (0-1 dacrocytes/feld), mild (2-5/feld), moderate (6-15/feld) and severe (>15/feld). Te following information was obtained from Rojas-Maya, J Bone Res 2016, 4:2 DOI: 10.4172/2572-4916.1000167 Research Article Open Access J Bone Res, an open access journal Volume 4 • Issue 2 • 1000167 Journal of Bone Research J o u r n a l o f B o n e R e s e a r c h ISSN: 2572-4916