What Is Basophilic Stippling?

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  • Written By: Jillian O Keeffe
  • Edited By: PJP Schroeder
  • Last Modified Date: 02 June 2019
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Basophilic stippling is a term that refers to a specific appearance of a red blood cell under the microscope. It is an abnormal collection of nucleic acid in dots throughout the cell and indicates the presence of disease. The stippling is only obvious in the cell after it has been stained with a particular sort of dye.

Stippling is a word that means something looks like it is covered in dots. Basophilic means that the cells that show the stippling are stained with a basic dye. A basic dye is alkaline and interacts with the negatively charged molecules inside a cell to produce a coloration. Stains such as the Wright-Giemsa-Gram type can make the stippling obvious to the eye when the image of the cell has been magnified under a laboratory microscope.

Under the microscope and after staining, cells with basophilic stippling tell the analyst that some of the nucleic acid material is not in its normal place. The colored clumps are collections of ribonucleic acid (RNA) and mitochondria. In healthy cells, the RNA and mitochondria do not clump up, so normal cells do not show stippling but instead appear smooth and regularly colored.


In cases of suspected disease, examinations of cells under the microscope can give a medical professional clues as to what illness is present. Basophilic stippling on red blood cells can indicate the presence of several different medical conditions. Lead poisoning is most associated with the finding of basophilic stippling, and in this situation, the clumps arise because the nucleotidase enzyme that breaks down RNA, which is old and no longer required, is affected by the poison.

With lead poisoning, both old and young cells have a stippled appearance after staining. Often, the affected blood contains more red blood cells than usual. Symptoms like vomiting, headache, and a propensity to lose lots of weight can be taken into consideration, along with basophilic stippling, to diagnose lead poisoning in a patient.

As well as lead poisoning, various forms of anemia can be diagnosed through the appearance of stippling on affected people's red blood cells. Normally, in anemic patients, the stippling is most obvious in young red blood cells. Blood poisoning, a situation where a microbial infection gets into the blood, can also produce stippling. Other causes of stippling include certain drugs, and burn victims can also exhibit red blood cell stippling.


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