Price-Jones Curve – Red Blood Cell Size & Hematology
The Price-Jones curve is a graphical representation of the frequency distribution of red blood cell diameters. It is used to assess size variations in erythrocytes and to support the diagnosis of blood disorders.
Things worth knowing about "Price-Jones Curve"
The Price-Jones curve is a graphical representation of the frequency distribution of red blood cell diameters. It is used to assess size variations in erythrocytes and to support the diagnosis of blood disorders.
What Is the Price-Jones Curve?
The Price-Jones curve is a diagnostic tool in hematology that graphically displays the frequency distribution of erythrocyte (red blood cell) diameters in a blood sample. The method was developed and named after the British physician and hematologist Cecil Price-Jones in the early 20th century.
In healthy individuals, red blood cells have a relatively uniform diameter of approximately 6.7 to 7.7 micrometers, resulting in a narrow, symmetrical bell-shaped curve. Deviations from this normal distribution provide valuable diagnostic clues regarding various blood disorders.
Methodology
To construct a Price-Jones curve, the diameters of a large number of erythrocytes are measured – classically using light microscopy or modern automated hematology analyzers – and plotted as a histogram or frequency curve. The x-axis represents cell diameter in micrometers, while the y-axis shows the relative frequency of each size category.
- Normal finding: Mean erythrocyte diameter of approximately 7.2 micrometers, narrow and symmetrical curve.
- Left shift: Predominance of smaller cells, characteristic of microcytosis (e.g., iron deficiency anemia, thalassemia).
- Right shift: Predominance of larger cells, characteristic of macrocytosis (e.g., vitamin B12 or folate deficiency).
- Broadened curve: Indicates anisocytosis, meaning pronounced variability in red blood cell size.
Clinical Significance
The Price-Jones curve is a foundational concept in hematological diagnostics. In modern laboratory medicine, the size distribution of red blood cells is primarily quantified by the RDW (Red Cell Distribution Width) parameter in the complete blood count. Despite this, the Price-Jones curve retains historical and educational importance, as it clearly illustrates the clinical relevance of erythrocyte size variation.
Conditions Associated with an Altered Curve
- Iron deficiency anemia: Left shift due to an increased number of small (microcytic) erythrocytes.
- Megaloblastic anemia (vitamin B12 or folate deficiency): Right shift due to enlarged (macrocytic) erythrocytes.
- Thalassemia: Left shift with very small, hypochromic erythrocytes.
- Hemolytic anemia: Broadened curve reflecting varying cell sizes resulting from increased erythropoiesis.
- Myelodysplastic syndrome (MDS): Pronounced anisocytosis with a wide, irregular curve.
Diagnosis and Modern Equivalent
In current clinical practice, the visual Price-Jones curve has largely been replaced by the automatically calculated RDW value in the automated complete blood count. An elevated RDW corresponds to a broadened Price-Jones curve and signals the presence of anisocytosis. However, microscopic examination of a blood smear – and thus the direct visual assessment of erythrocyte size – may still provide valuable supplementary information in certain diagnostic scenarios.
Summary
The Price-Jones curve is a fundamental hematological concept for assessing the size distribution of red blood cells. It enables the recognition of different forms of anemia and other blood disorders through characteristic changes in curve shape. Its modern equivalent is the RDW value generated by automated blood analyzers.
References
- Price-Jones, C.: Red Blood Cell Diameters. Oxford University Press, London 1933.
- Buttarello, M., Plebani, M.: Automated blood cell counts: state of the art. American Journal of Clinical Pathology, 130(1):104-116, 2008. PubMed PMID: 18550479.
- Lffler, H., Rastetter, J., Haferlach, T. (Eds.): Atlas of Clinical Hematology. 6th Edition. Springer, Berlin/Heidelberg 2004.
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