Burr cells are crenated red cells, also known as echinocytes. Crenated red cells have changed from a disc shape to spheres covered with short, sharply pointed projections
they are usually artefactual but may be seen in conditions such as uraemia, GI bleeding and stomach carcinoma
artefactual crenation may be due to slow drying of the smear or aging of blood in the tube. Older red cells, whether aged in circulation or in the tube, are more likely to undergo the discocyte-echinocyte transformation than younger red cells.
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