Echinocyte (from the Greek word echinos, meaning ‘hedgehog’ or ‘sea urchin’), in human biology and medicine, refers to a form of red blood cell that has an abnormal cell membrane characterized by many small, evenly spaced thorny projections. A more common term for these cells is burr cells.



Smaller, round RBCs displaying many regular sharp spikes/projections from the membranes.


Some degree of echinocytosis will be present in all samples. This finding becomes more significant when observed in great numbers – exceeding 5 and in many viewing fields.



This condition can be an artifact if the blood is overexposed to ambient air or pressurized.     

Kidney Stress Kidney Stress Kidney Stress Kidney Stress       

Uremia, related to kidney disease (kidney failure).    

Vitamin E Deficiency Vitamin E Deficiency Vitamin E Deficiency Vitamin E Deficiency   

Fluid – Electrolyte imbalance / Dehydration

Some Prescription Drugs (that influence fluid-electrolyte balance or cause kidney stress)

Toxicity / Free Radicals

Environmental Toxins

Abnormal lipid content of the plasma due to an accumulation of fatty acids and/or lysolecithin on the RBC membrane.  

Associated Symptoms:    


A myriad of symptoms related to toxicity (headaches, malaise, skin conditions, etc.)

Thirst, Cramps and signs of dehydration.   


Pleomorphic Perspective:   

These forms occur when ascits develop in the interior of the RBC and are penetrating the membrane. A pathological condition in the body is accompanied by accumulated toxins and endobiontic progression which damages the blood cells. Antioxidants will protect the cells from free radical damage, but not from the endobiont, as it is indestructible and will persist and increase in valence as long as the terrain in the body allows for it.  


Medical Perspective:

Echinocytosis (crenated erythrocytes) is usually not an indicator of a pathological problem, but most often an artifact. Echinocytes can be produced in vitro by incubation at high pH or in the presence of high calcium concentrations, exposure to glass surfaces, reduced albumin concentrations and after prolonged storage. Echinocytes have been demonstrated in both endstage renal disease and in liver disease. In the latter setting, an abnormal high-density lipoprotein binds to receptors on the outer surface of the red cell membrane and induces the characteristic conformational changes. Echinocytosis is also observed in acute blood loss, stomach cancer and pyruvate kinase deficiency.  



Increase water intake Increase water intake Increase water intake Increase water intake. To determine necessary daily water intake (in litres): (Weight in kg ÷ 8) x 0.25.  

Vitamin E: start with 400mg daily and gradually increase to 800mg daily.  

Increase essential minerals and electrolyte intake

Detoxification program

Kidney supportive herbs

Antioxidant supplements, including a combination of the following: Super Oxide Dismutase, proanthocyanidins, N-Acetyl Cysteine, buffered vitamin C, vitamin E (400mg), selenium (200ug), beta carotene, zinc and glutathione.   

Stop smoking

Avoid caffeine, alcohol and other diuretics.


Further Investigations:

FBC + differential + ESR


Urea, Electrolytes & Creatinine (UE+C)


Serum Uric Acid

TNF (Tumor Necrosis Factor) + Tumor markers  


Copyright Dr Okker R. Botha, Johannesburg, South Africa, 2009