Reticulocytosis is a condition where there is an abnormally large number of immature red blood cells in the circulation, which can indicate a problem with the marrow or blood. It can be expected after hemorrhage or malnutrition, but can also be an indicator of hemolytic anemia or another blood condition. Treatment depends on the underlying cause. Recent blood transfusions or massive blood loss can affect test results.
Reticulocytosis is an abnormally large number of immature red blood cells in the circulation. The bone marrow normally produces and releases these cells on a regular basis to replace aged and destroyed cells. Large numbers may indicate that there is a problem with the marrow or blood, or it may be a response to sudden blood loss. Laboratory tests can identify the concentration of reticulocytes in the blood and determine whether a patient’s blood has other abnormalities, such as low or high numbers of other cell types.
In some cases, reticulocytosis can be expected. A patient who has just had a hemorrhage should have a large number of immature cells circulating because the bone marrow is rushing to replace them. A history of malnutrition may also be a contributing factor. The bone marrow needs a certain number of nutrients to make red blood cells, and if it has been deprived, supplementation could cause a spike in reticulocytes as it recovers and starts making them again.
It can also be an indicator of a problem in some patients. In hemolytic disorders, the body begins to destroy mature, healthy blood cells, which can lead to anemia, where there aren’t enough red blood cells circulating to meet the body’s needs. Reticulocytosis can be seen with such disorders as the bone marrow struggles to keep up with the rate of destruction. Technicians and pathologists evaluating the blood of a patient with suspected hemolytic anemia might expect to find a low number of mature cells and a large number of immature cells.
The best treatment option for reticulocytosis may depend on why the patient has it. If it is associated with recovery from a condition for which the patient is already being treated, a wait-and-see approach may be advised. Doctors may order a second blood test to confirm that values have returned to normal once the patient has had a chance to stabilize. When it is an indicator of hemolytic anemia or another blood condition, treatment for that condition should resolve the reticulocytosis.
Patients who have recently had blood transfusions should make sure their care providers are aware of this. The transfusion could alter your blood values and create a false picture. It may be advisable to wait or consider the transfusion when evaluating the results. Any recent history of massive blood loss can also change the interpretation of results and should be noted in the patient’s medical record.
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