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Peripheral blood smear of a 38-year-old female with long-standing Crohn's disease (CD) and development of microcytic anemia.
The smear shows numerous target cells and a spur cell (top right).All liver function tests were abnormal indicating that the target cells are due to liver disease secondary to CD. This patient originally had concomitant iron deficiency.
Spur red cells have elongated projections while Burr cells are red cells with circulferential blunted borders. The former is typically seen in liver disease while the latter is seen in uremia. The "Burr" morphology in this case is artifactual related to slide preparation and not related to uremia.