Understanding Your Laboratory Test: A Patient Guide
A blood test that counts abnormal spiky red blood cells to help diagnose certain liver and metabolic disorders.
{"Acanthocytes are abnormally shaped red blood cells with spiky projections","This test helps diagnose liver disease and rare metabolic disorders","The test is performed on a regular blood sample","High counts may indicate liver problems or genetic conditions","Results help doctors determine the cause of anemia and other symptoms"}
Key facts at a glance
- LOINC
- 51639-3
- Short code
- ACAN
- Synonyms
- Acanthocytes/1000 RBC NFr Bld Smear
- Category
- chemistry
- Sample
- whole-blood
- Container
- EDTA tube (lavender top / purple top) - K2 EDTA or K3 EDTA anticoagulated whole blood
- Units
- N/A
- Ref low
- 0
- Ref high
- 5
- Critical range
- 2 N/A – 7 N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- ≥ 0 years
- Method
- microscopy-light
- CPT
- 85060
- SNOMED
- 70819002
- Specimen volume
- 3-5 mL whole blood; minimum 1 mL acceptable
- Stability
- Room temperature: 4-6 hours optimal; refrigerate at 2-8°C: up to 24 hours acceptable. Do not freeze. Analyze as soon as possible for optimal morphological preservation.
- Hemolysis max
- 0
- Lipemia max
- 0
- Icterus max
- 0
- TAT
- 24–72 hours
- Order
- routine
This is a laboratory test that helps your healthcare provider evaluate important markers in your body. It may involve a small sample of blood, urine, or another body fluid, which is sent to a lab and analyzed to give your care team useful information about your health.
The acanthocyte count test examines your blood under a microscope to count how many out of 1,000 red blood cells are acanthocytes. Acanthocytes (also called spur cells) are red blood cells that have an abnormal shape with irregular, spiky projections on their surface. This test helps doctors identify conditions that cause these abnormal cells to form.
Your provider may order this test to check for a medical condition, investigate symptoms you have been having, screen for health problems before they cause trouble, or monitor how well an existing condition or its treatment is being managed over time.
Your doctor may order this test if you have symptoms like fatigue, jaundice (yellowing of skin or eyes), an enlarged spleen, or unexplained anemia. The test helps determine if your symptoms are caused by liver disease or a rare genetic disorder called abetalipoproteinemia. It may also be used to monitor your condition if you've already been diagnosed with a related disease.
The sample is usually collected at a clinic, hospital, or laboratory. For a blood test, a small needle is used to draw blood from a vein in your arm; for urine or swab tests, you will be given simple instructions. The collection itself usually takes only a few minutes.
A healthcare professional will draw a small blood sample from a vein in your arm, usually in the morning after fasting. The sample is then sent to a laboratory where a technician examines it under a microscope. They count 1,000 red blood cells and record how many are acanthocytes. The entire process takes only a few minutes for the blood draw, with results typically available within a few days.
Your results are compared with established reference ranges to show whether your values are within the expected range. Values outside that range may point to a condition that needs further evaluation, but many factors can affect results. Always discuss your results with your healthcare provider to understand what they mean for you.
Normal blood has very few or no acanthocytes. A high percentage (usually above 5-10% of red blood cells) may indicate an underlying health condition. Your doctor will interpret your results along with other tests and your symptoms to determine the cause and appropriate treatment.
Reference range
0-5% acanthocytes (0-50 cells per 1000 erythrocytes); <5% considered normal/physiologicN/A
No special preparation required. Test can be performed as part of routine CBC or specifically ordered. Inform patient that this is a manual microscopic examination of blood cells.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Elevated acanthocyte counts are primarily associated with liver diseases, particularly advanced cirrhosis and alcoholic liver disease. The abnormal cell shape occurs because of changes in the lipid (fat) composition of the red blood cell membrane. This test is also crucial for diagnosing abetalipoproteinemia, a rare genetic disorder that affects fat metabolism and causes severe vitamin deficiencies. Other conditions that may show acanthocytosis include post-splenectomy status, hypothyroidism, and certain types of hemolytic anemia. The test helps differentiate between various causes of anemia and guides appropriate treatment decisions.
Frequently asked questions
Does this test require special preparation?
Is the test painful?
What happens if my results are abnormal?
Can acanthocytes be treated or reversed?
How often do I need this test?
Sources
- 1
- 2
- 3
Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 17, 2026. · Read our editorial policy