In which condition may peripheral blood smear show spherocytes?

In autoimmune hemolytic anemia, the peripheral blood smear characteristically reveals the presence of spherocytes. Spherocytes are red blood cells that are smaller and rounder than normal, lacking the typical biconcave shape. This change occurs due to the immune system mistakenly attacking and destroying the red blood cells, often by coating them with antibodies. The spleen then recognizes these antibody-coated cells as damaged and removes them from circulation, leading to the formation of the spherocytes from the remaining intact cells.

The development of spherocytes is a hallmark of autoimmune hemolytic anemia because the condition is specifically associated with the destruction of red blood cells due to this autoimmune process. The presence of spherocytes helps differentiate autoimmune hemolytic anemia from other anemias that do not typically present with this finding.