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reticulocytes

Normal Values

The normal range depends on the level of hemoglobin, and the range is higher if there is low
hemoglobin due to bleeding or red cell destruction.

What do Abnormal Results Mean?

A higher-than-normal percentage of reticulocytes may indicate:

• Bleeding
• Erythroblastosis fetalis
• Hemolytic anemia
• Kidney disease with increased erythropoietin production

A lower-than-normal percentage of reticulocytes may indicate:

• Bone marrow failure (for example, from drug toxicity, tumor, or infection)
• Cirrhosis of the liver
• Folate deficiency
• Iron deficiency
• Kidney disease with decreased erythropoietin production
• Radiation therapy
• Vitamin B-12 deficiency

Overall, the most common causes of excessive bleeding include

• Severe thrombocytopenia

• Excessive anticoagulation with warfarin or heparin

• Liver disease (inadequate production of coagulation factors)

Table 2

Some Causes of Excessive


Bleeding

Category Examples

Platelet disorders

Decreased number Inadequate production (eg,

of platelets leukemias, aplastic anemia,


(quantitative some myelodysplastic

disorder) syndromes)

Splenic sequestration (eg, in

cirrhosis with congestive

splenomegaly)

Increased platelet

destruction or consumption

(eg, idiopathic

thrombocytopenic purpura,

DIC, thrombotic

thrombocytopenic purpura,

hemolytic-uremic syndrome,

sepsis, HIV infection)

Drug-induced destruction

(eg, heparin, quinidine SOME

TRADE NAMES

CARDIOQUIN

QUINAGLUTE

Click for Drug Monograph

, quinine SOME TRADE NAMES

QUALAQUIN

Click for Drug Monograph

, sulfonamides,

sulfonylureas, rifampin SOME

TRADE NAMES

RIFADIN

RIMACTANE

Click for Drug Monograph

, gold salts)

Increased number Essential thrombocythemia

of platelets (thrombosis may be more

(quantitative common than bleeding)

disorder)

Inadequate Von Willebrand's disease

platelet function (inadequate VWF-mediated

(qualitative platelet adhesion)

disorder)
Drug-induced dysfunction

(eg, aspirin SOME TRADE

NAMES

BUFFERIN
ECOTRIN

GENACOTE

Click for Drug Monograph

, NSAIDs)

Systemic disorders (uremia;

occasionally,

myeloproliferative or

myelodysplastic syndromes,

multiple myeloma)

Coagulation disorders

Acquired Vitamin K deficiency

Liver disease

Anticoagulation with warfarin

or heparin

DIC

Hereditary Hemophilia A (factor VIII

deficiency)

Hemophilia B (factor IX

deficiency)

Vascular disorders

Acquired Vitamin C deficiency

Henoch-Schönlein purpura

Hereditary Connective tissue disorders

(eg, Ehlers-Danlos

syndrome, osteogenesis

imperfecta, Marfan

syndrome)

Hereditary hemorrhagic

telangiectasia

DIC = Disseminated intravascular


coagulation; VWF = von Willebrand's
factor.

Evaluation

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