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Low levels of EPO (around 10 mU/mL) are constantly secreted in sufficient quantities to compensate for normal red blood cell turnover. Common causes of cellular hypoxia resulting in elevated levels of EPO (up to 10 000 mU/mL) include any anemia, and hypoxemia due to chronic lung disease and mouth disease. Erythropoietin is produced by ...
Patients usually have a very low level of erythropoietin, a growth factor that increases the production of red blood cells, which may be considered a minor diagnostic feature. A mutation in the JAK2 kinase (V617F) is strongly associated with polycythemia vera.
The anticonvulsant drug, lamotrigine, has been associated with a decrease in white blood cell count. [2] The FDA monograph for metronidazole states that this medication can also cause leukopenia, and the prescriber information suggests a complete blood count, including differential cell count, before and after, in particular, high-dose therapy. [3]
Therefore, the upregulation of white blood cells causes fewer stem cells to differentiate into red blood cells. This effect may be an important additional cause for the decreased erythropoiesis and red blood cell production seen in anemia of inflammation, even when erythropoietin levels are normal, and even aside from the effects of hepcidin.
Depending on findings on initial evaluation, may consider investigating the cause of low reticulocyte count with some of the following studies depending on patient presentation and differential diagnoses: Bone marrow aspiration and evaluation; Parvovirus B19 IgG/IgM [3] Erythropoietin level [7] Rheumatalogic studies
Anabolic steroid use – people whose testosterone levels are high, including athletes who abuse steroids, people on testosterone replacement for hypogonadism or transgender hormone replacement therapy. [17] Blood doping – Athletes who take erythropoietin-stimulating agents or receive blood transfusions to increase their red blood cell mass. [28]
Preterm infants are often anemic and typically experience heavy blood losses from frequent laboratory testing in the first few weeks of life. [4] Although their anemia is multifactorial, repeated blood sampling and reduced erythropoiesis with extremely low serum levels of erythropoietin (EPO) are major causative factors.
In spite of an increased level of transferrin, serum iron level is decreased along with transferrin saturation. Erythropoiesis impairment begins when the serum iron level falls to less than 50 μg/dL and transferrin saturation is less than 16%. [4] Stage 3 – Anemia (reduced hemoglobin levels) is present but red blood cell appearance remains ...
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