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Transient decrease in erythropoiesis resulting in low reticulocyte count with decrease in hemoglobin >/= 3 g/dL is considered to be aplastic crisis. [8] For the decrease in all cell lineages (pancytopenia), see aplastic anemia.
The presence of Heinz bodies represents damage to hemoglobin and is classically observed in G6PD deficiency, a genetic disorder that causes hemolytic anemia. In veterinary medicine, Heinz bodies may be seen following the consumption of foods containing thiosulfate and propylene glycol compounds by cats, dogs and certain primates.
A reticulocyte percentage that is higher than "normal" can be a sign of anemia, but this depends on the health of a person's bone marrow. Calculating the reticulocyte production index is an important step in understanding whether or not the reticulocyte count is appropriate to the situation. This is often a more important question than whether ...
The problem arises because the reticulocyte count is not really a count but rather a percentage: it reports the number of reticulocytes as a percentage of the number of red blood cells. In anemia, the patient's red blood cells are depleted, creating an erroneously elevated reticulocyte count. [1]
If a low count of reticulocytes is found, it usually indicates bone marrow stress. If a high reticulocyte count is found, it is usually linked to hemolysis, but a Coombs test may be performed in this case to rule out immune-mediated hemolysis. [4] Polychromasia can also be seen in blood smears when there is a normal reticulocyte count.
In addition, erythropoietin is bound by circulating red blood cells; low circulating numbers lead to a relatively high level of unbound erythropoietin, which stimulates production in the bone marrow. Recent studies have also shown that the peptide hormone hepcidin may play a role in the regulation of hemoglobin production, and thus affect ...
For non-megaloblastic macrocytic anemias, a reticulocyte count may be helpful. Non-megaloblastic macrocytic anemias with a low reticulocyte count (indicating a poor bone marrow response to the anemia) suggest liver disease (e.g., cirrhosis), hypothyroidism, toxic effects of alcohol on the bone marrow, or myelodysplasia. [2]
** Confirm by repeating reticulocyte count: ongoing combination of low reticulocyte production index, normal MCV and hemolysis or loss may be seen in bone marrow failure or anemia of chronic disease, with superimposed or related hemolysis or blood loss. Here is a schematic representation of how to consider anemia with MCV as the starting point: