Echinocytes are covered in regularly spaced protusions, giving them their name meaning ‘hedgehog cell’, they are also referred to as burr cells. They can be confused with acanthocytes. Erythrocyte shape depends on balancing osmotic pressure via the control of ion movement across the plasma membrane. Ion transport requires energy in the form of ATP, for which erythrocytes are completely reliant on glucose as an energy source. To increase the efficiency of glucose utilisation, the glycolytic enzymes are recruited to cytoskeletal anchor points at the membrane to form metabolic islands of macromolecular complexes, consisting of the glucose transporter transmembrane proteins and the various enzymes on the intracellular surface. Genetic variations in pyruvate kinase, the enzyme responsible for the final step in ATP production, disrupt energy generation. These are one of the most common causes of non-spherocytic haemolytic anaemia and are often associated with echinocytes.
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