The morphology of normal erythrocytes and of acanthocytes from five patients with abetalipoproteinemia was studied by two relatively new technics. Interference microscopy with Nomarski optics was used to study the red blood cells in the living state; the scanning electron microscope was utilized to give a three dimensional appearance of the fixed red blood cells.

Isotonic saline washing of normal red blood cells produces multiple small uniform projections on the surface of the cell: the crenated red cell. Acanthocytes after saline washings also develop similar projections: the crenated acanthocyte. Crenation of both the normal red blood cell and the acanthocyte is reversed by restitution of a plasma environment and by chemical fixation by glutaraldehyde or osmic acid but the characteristic shape of the acanthocyte is preserved.

A comparison was made of the changes in the shape of the normal red blood cells and acanthocytes induced by alterations in the tonicity of the surrounding medium.

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