Medical Test Overview: What This Test Is, How It Is Performed, and What Your Results Mean
A blood test that examines red blood cells under a microscope to detect the presence of basophilic stippling, which are small blue-purple granules that may indicate certain medical conditions.
{"Basophilic stippling appears as tiny dots inside red blood cells when viewed under a microscope","This test helps doctors identify conditions like lead poisoning, thalassemia, or certain anemias","The test is performed on a peripheral blood smear, a common and relatively simple procedure","Results help determine if further testing or treatment is needed","This is not a routine screening test and is usually ordered when specific conditions are suspected"}
Key facts at a glance
- LOINC
- 104798-4
- Short code
- BSB
- Synonyms
- Baso Stipl Bld Ql
- Category
- chemistry
- Sample
- whole-blood
- Container
- EDTA (lavender/purple-top) vacuum blood collection tube; sodium heparin (green-top) tube is also acceptable. EDTA is preferred for optimal red cell morphology preservation.
- Units
- N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 0–120 years
- Method
- Manual microscopic examination of Wright-stained or May-Grünwald-Giemsa-stained peripheral blood smear under high-power (1000x oil immersion) microscopy; may be supplemented by automated digital morphology analyzers.
- CPT
- 85007 (Blood smear, microscopic examination with manual differential WBC count) or 85008 (Blood smear, microscopic examination without manual differential WBC count)
- SNOMED
- 165388001 (Basophilic stippling - finding) or 250422002 (Lead poisoning)
- Specimen volume
- 1-3 mL of whole blood (minimum 0.5 mL in pediatric microtainer tubes).
- Stability
- Specimen is stable for up to 4 hours at room temperature (20-25°C); may be refrigerated (2-8°C) for up to 24 hours. Best results obtained from fresh smears prepared within 1-2 hours of collection to minimize artefactual changes such as crenation, sphering, or inclusion degeneration.
- Hemolysis max
- 0
- Lipemia max
- 0
- Icterus max
- 0
- TAT
- 2–8 hours
- Order
- routine
What is this test, and why might my healthcare provider recommend it as part of my care?
The basophilic stippling test examines a sample of your blood under a microscope to look for the presence of basophilic stippling in red blood cells. Basophilic stippling refers to small blue-purple granules that appear inside red blood cells. These stippled cells are also known as stippled erythrocytes. The test is performed as part of a peripheral blood smear examination, where a drop of blood is spread on a glass slide, stained, and then examined by a laboratory professional.
How is this test performed, and what can I expect before, during, and after the procedure?
A healthcare provider will collect a small blood sample from a vein in your arm using a needle. This sample is then sent to a laboratory where it is prepared as a peripheral blood smear. The smear is stained with special dyes that allow the lab technician to see the blood cells clearly under a microscope. The technician will look for the presence and quantity of red blood cells containing basophilic stippling. Since this test is part of a complete blood smear, it does not require any special preparation, and the risks are minimal, similar to any routine blood draw.
What do the results of this test mean, and how will my healthcare provider use them to guide my treatment?
The result is typically reported as either 'present' or 'absent' for basophilic stippling. If basophilic stippling is present, it indicates that your body may be producing abnormal red blood cells. This finding is not a diagnosis by itself but rather a clue that helps your doctor determine what may be causing the problem. Your doctor will consider these results along with your symptoms, medical history, and other test results to determine the appropriate next steps.
Reference range
Negative (basophilic stippling not observed). Presence of coarse basophilic stippling is considered abnormal and clinically significant.N/A
No special patient preparation required. Fasting is not necessary. Patients should inform their healthcare provider of any recent occupational or environmental exposure to heavy metals (e.g., lead, arsenic) and any current medications, including iron chelators or chemotherapeutic agents.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Basophilic stippling in blood cells is associated with several medical conditions. The most common cause is lead poisoning (lead intoxication), where the stippling occurs due to interference with hemoglobin production. Other conditions associated with basophilic stippling include thalassemia (a genetic blood disorder affecting hemoglobin), sideroblastic anemia (a condition where the body has trouble incorporating iron into hemoglobin), myelodysplastic syndromes (disorders where the bone marrow does not produce enough healthy blood cells), and certain infections. The presence and amount of basophilic stippling can help doctors differentiate between these conditions and guide further diagnostic testing and treatment.
Frequently asked questions
Why would my doctor order this test?
Is fasting required before this test?
Does having basophilic stippling mean I have a serious disease?
What happens if my test shows basophilic stippling?
Can basophilic stippling be treated?
Sources
- 1
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- 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 16, 2026. · Read our editorial policy