Polychromasia is a disorder where there is an abnormally high number of immature red blood cells found in the bloodstream as a result of being prematurely released from the bone marrow during blood formation ( poly - refers to many, and -chromasia means color .) This content does not have an English version. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Anemia can affect your weight, whether due to its impact on your appetite and activity levels or its underlying cause. People with other types of anemia, like sickle cell anemia or thalassemia, may require blood transfusions to treat their condition. She was a non-smoker and before she was pregnant she rarely drank alcohol . Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. National Health Service. Click here for an email preview. It may also be caused other blood diseases or by certain drugs used to treat cancer. Dr said rbc morphology my 5yo is normal but when i got the report it said spherocytes and polychromasia is 3-5/hpf. Anisopoikilocytosis means having both anisocytosis and poikilocytosis. The number of reticulocytes, however, reflects the amount of erythropoiesis that has occurred on any certain day. Polychromasia can be a sign of a serious blood disorder, such as hemolytic anemia or blood cancer. But uncontrolled thrombocythemia can lead to miscarriage and other complications. The liver is then used as the main hematopoietic organ of the embryo until near birth, where it is then taken over by the bone marrow. Review/update the In this article, well discuss what polychromasia is, what blood disorders can cause it, and what the symptoms might be for those underlying conditions. This means that the amount of red blood cells showing varying sizes and shapes is more moderate. This content does not have an English version. Sickle cell anemia and thalassemia are two types of inherited hemolytic anemia. Great to know However, with polychromasia, some stained red blood cells may appear blue, bluish gray, or purple. Once microcytosis is diagnosed, the history can sometimes provide clues to the underlying etiology. A serum lead test can detect lead toxicity, and the Centers for Disease Control and Prevention provide guidelines on which high-risk groups of children to screen.26,27 Even in the presence of lead toxicity, microcytic anemia can be caused by coexisting iron deficiency anemia.28. Mild cases of polyhydramnios may go away on their own. If you're not getting enough iron, you may develop iron-deficiency anemia. Additionally, iron chelation is often needed. Red blood cell distribution width: A simple parameter with multiple clinical applications [Abstract]. concern? Some anemias and vitamin deficiencies are easily treatable. People with thalassemia typically require repeat blood transfusions for treatment. Adewoyin AS, et al. (last 2 years showed: poikilocytosis & mild neutropenia). both (some larger and some smaller than normal). Developing RBCs still need to make proteins, so they still have a nucleus and protein-making structures called ribosomes. These include hydroxychloroquine (Plaquenil), rituximab (Rituxan) and statins. It is much easier to test for polychromasia in blood cells than to perform special staining for reticulocytosis. It is critical to exclude gastrointestinal malignancy in men and nonmenstruating women.5,9,21,22 Gastrointestinal sources of blood loss should also be considered in menstruating women and adolescent girls when the anemia is refractory to iron treatment or when gastrointestinal symptoms are present.23,24, If the serum ferritin level is not consistent with iron deficiency anemia, the next stage of the evaluation should include measurement of serum iron level, TIBC, and transferrin saturation. These types of conditions can result in increased blood loss and the destruction of RBCs, which in turn can increase RBC production. The life span of a typical red blood cell is acknowledged to be approximately 120 days, and the time period of a reticulocyte found in the blood to be one day. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Bone marrow dysfunction may also cause the body to overcompensate and release RBCs early. There are many different types of anemia. A peripheral blood smear is often performed along with a complete blood count (CBC). Polychromasia refers to presence of Hypochromasia=cells with less dense color; polychromasia=cells with variation in density of color, smudge cells= look less distinct under direct exam, All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Dr. Gurmukh Singh and another doctor agree. Healthline Media does not provide medical advice, diagnosis, or treatment. This means that the amount of red. Polychromasia (polychromatophilic cells) in a neonate. This measure is usually increased in iron deficiency, decreased in anemia of chronic disease, and normal in the less severe thalassemias. Howell was the first to describe these blood cells as being of the prototype stippling, which meant granular degeneration of the red blood cells. [7] In 1893, Max Askanazy, who was studying the blood of an anemic patient, discovered granulation in the blood cells that were polychromatic. (2015). Severe polyhydramnios may require closer monitoring. More information about each condition and how they affect RBC production follows the table. should this be checked into? Your doctor may also order tests to assess your hemoglobin, iron, folate, or vitamin B-12 levels. They will likely ask you questions about your familys medical history as well as your own. Anemia can be dangerous for the fetus for these reasons: If left untreated, anisocytosis or its underlying cause can lead to: The long-term outlook for anisocytosis depends on its cause and how quickly youre treated. Be sure to tell your doctor if you have any other symptoms or if youre taking any medications. Hemolytic anemia can be inherited, meaning you had it when you were born, or acquired, which means you developed it later in life. Iron-deficiency anemia is the most common type of anemia and occurs when the body doesn't have enough iron. Under certain conditions, these red blood cells are shown to have an affinity for basic stains, contrary to the usual acid stains used. All rights reserved. While. Beta-thalassemia is an autosomal recessive genetic condition in which the normal beta globin chains that make up hemoglobin are underproduced. A bone marrow transplant could also be performed. However, other research has shown that there has been stippling found in normal blood cells as well. hereditary elliptocytosis, an inherited disease in which red blood cells are oval or egg-shaped, psychological problems, including confusion, memory, and judgment issues, pregnancy complications, including early delivery or birth defects, heart issues due to quick or irregular heartbeat, severe infections in people with thalassemia due to repeated blood transfusions or spleen removal. Transferrin saturation is a percentage calculated as serum iron concentration/TIBC 100. (2016). 2020;25(1):48-54. doi:10.1080/16078454.2019.1711344, Stauder R, Valent P, Theurl I. https://www.uptodate.com/contents/search. Both are more common in black persons, and in persons of Southeast Asian, Greek, Italian, or Mediterranean descent.30, Most patients with beta-thalassemia trait have mild anemia (hemoglobin level is rarely less than 9.3 g per dL [93 g per L]). Pregnant women with anisocytosis should take the condition seriously, because anemia can cause pregnancy complications. low levels of white blood cells and platelets, pregnancy complications, including serious birth defects in the spinal cord and brain of a developing fetus (neural tube defects). A high percentage of polychromatophilic cells (reticulocytes) may result in an increased MCV and decreased MCH or MCHC. The fetus might not be getting enough oxygen. A value less than 16 percent is often indicative of iron deficiency anemia.16, Ferritin is a complex of iron and the binding protein apoferritin.17 Ferritin reflects true iron stores and is not susceptible to the short-term variations that occur with serum iron levels and TIBC. There are no symptoms directly associated with polychromasia. doi:10.3945/ajcn.116.143073, Ford ND, Bichha RP, Parajuli KR, et al. Polyhydramnios (pol-e-hi-DRAM-nee-os) is the excessive accumulation of amniotic fluid the fluid that surrounds the baby in the uterus during pregnancy. Heavy alcohol drinking is known to further aggravate anemia. http://www.merckmanuals.com/professional/gynecology-and-obstetrics/abnormalities-of-pregnancy/polyhydramnios. Polychromasia refers to macrocytic (large) red blood cells with a bluish tinge, due to residual RNA. Common causes of macrocytosis include: If you have macrocytosis, blood tests can help determine its cause. [5] Most red blood cells are released into the blood as reticulocytes. We avoid using tertiary references. When you don't have enough red blood cells for your organs and tissues to get as much oxygen as they need, you develop anemia. (2014). 7th ed. All rights reserved. Mayo Clinic, Rochester, Minn. Oct. 11, 2017. It's an indication of red blood cells being released prematurely from bone marrow during formation. Accessed April 17, 2019. Epidemiology of aplastic anemia: a study of 1324 cases. The anemia is usually mild and not progressive. Normal RBCs (also called erythrocytes) are typically disk-shaped, are thinner in the middle than in the edges, with a diameter of 6.2 to 8.2 micrometers, a thickness at the thickest point of 2 to 2.5 micrometers, and a thickness in the center of 0.8 to 1 micrometers. There can be complications from the underlying condition thats causing anisopoikilocytosis. Severe polyhydramnios may cause shortness of breath, preterm labor, or other signs and symptoms. While polychromasia itself isnt a condition, it can be caused by an underlying blood disorder. Anisopoikilocytosis is when you have red blood cells that are of different sizes and shapes. Polychromasia is increased in hemolysis, blood loss, and marrow infiltration. Polychromasia refers to a condition in which red blood cells (RBCs) appear grayish-blue in color when examined on a blood smear slide under a microscope. By Mayo Clinic Staff They are larger than mature red cells, and are bluish in color. Hematology. Does Anemia Cause Weight Loss or Weight Gain? EPO is usually released in response to anemia (a lowered number of RBCs in the blood), so anemia should be considered a cause of polychromasia. Lets look at why and what you can do about it. Thank you for submitting a comment on this article. Microcytosis is typically an incidental finding in asymptomatic patients who received a complete blood count for other reasons. Dietary deficiencies in iron, folate or vitamin B12 can cause production of fewer RBCs and cause those that are produced to have less of the oxygen-carrying protein, hemoglobin. Other diagnoses to consider include anemia of chronic disease, lead toxicity, and sideroblastic anemia. These include thalassemia and hereditary spherocytosis. Does Anemia Cause Weight Loss or Weight Gain? There are several different types of anemia that can lead to unequally sized RBCs, including: Other disorders that can cause anisocytosis include: In addition, certain drugs used to treat cancer, known as cytotoxic chemotherapy drugs, can result in anisocytosis. A high percentage of polychromatophilic cells (reticulocytes) may result in an increased MCV and decreased MCH or MCHC. See additional information. Beloosesky R, et al. 5-62) - these are the reticulocytes. (n.d.). Anisocytosis during pregnancy is most commonly caused by iron deficiency anemia. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. Polychromasia by itself doesn't cause symptoms. The smear offers a window into the functional status of the bone marrow, the factory producing all blood elements. Most of your blood is made up of red blood cells. 2005 - 2023 WebMD LLC, an Internet Brands company. Its an indication of red blood cells being released prematurely from bone marrow during formation. Talk to your medical team about the treatment options that are best for you. Mayo Clinic, Rochester, Minn. April 17, 2019. Dietary deficiencies in iron, folate or vitamin B12 can cause production of fewer RBCs and cause those that are produced to have less of the oxygen-carrying protein, hemoglobin. Polychromasia is a serious disease that causes blood issues in the person and leads to other issues. DOI: Mild to moderate anisopoikilocytosis (Code C96207). I apologize for my previous question. Treatment options may include: If youve been diagnosed with any of the conditions that can cause polychromasia, talk to your doctor about the safest, most effective treatment options for you. Conditions such as sickle cell anemia, hereditary spherocytosis, and thalassemia are inherited. Mayo Clinic does not endorse companies or products. (2015). There is a problem with Macrocytosis/macrocytic anemia. They may be significant if your Hemoglobin is low(Anemia). Blood 2005; 106 (3): 777. doi: https://doi.org/10.1182/blood.V106.3.777.777, Polychromatophilic red cells are marked by the arrows. RBCs are released prematurely in response to a certain type of hormone stimulation usually resulting from anemia or possibly due to structural damage to the bone marrow from a variety of causes. @kaybaymac, thank you so much!!! Underlying conditions that cause polychromasia, ncbi.nlm.nih.gov/pmc/articles/PMC4415389/, sciencedirect.com/topics/medicine-and-dentistry/polychromasia, seattlecca.org/diseases/blood-disorders/treatment-options, hopkinsmedicine.org/kimmel_cancer_center/types_cancer/paroxysmal_nocturnal_hemoglobinuria_PNH.html, urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=160&ContentID=34, Taking Control of Paroxysmal Nocturnal Hemoglobinuria, What You Need to Know About Paroxysmal Nocturnal Hemoglobinuria, Your FAQs Answered: What is Paroxysmal Nocturnal Hemoglobinuria (PNH), occurs due to an increased destruction of RBCs, causes an increased turnover of RBCs, can cause hemolytic anemia, blood clots, and bone marrow dysfunction the latter possibly bringing on early release of RBCs, symptoms of hemolytic anemia (listed above). Polychromasia (polychromatophilic cells) in a neonate. Doctors typically provide answers within 24 hours. Predictors of anemia in women of reproductive age: Biomarkers reflecting inflammation and nutritional determinants of anemia (BRINDA) project. Cause of anemia are decreased production of RBCs and production of RBCs that are defective in some way 1. [3][citation needed], There is a slight correlation between polychromasia and reticulocytosis. information submitted for this request. ", Patient: "Bone Marrow and Bone Marrow Failure.". Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. A group of 29 non-pregnant female and male rabbits were found to have ionized serum calcium levels of 1.71 + 0.11 mmol/L . possible causes of this polychromasia? Common types of anemia. Polychromasia is the presentation of multicolored red blood cells in a blood smear test. At that time, theyll be able to detect polychromasia on a blood smear if its present. Polychromatophilic cells are young red blood cells that have been recently released from the bone marrow. health information, we will treat all of that information as protected health The blood is stained to help differentiate the cells and then viewed under a microscope. Your risk of pregnancy complications may be reduced with regular checkups and medication, so be sure to have your doctor regularly monitor your condition. The table below lists the most common conditions that can cause polychromasia. Autoimmune hemolysis in pregnancy from a combination of warm and cold autoantibodies had been estimated to occur in 1 in 50000 pregnancies. 2019;21(Suppl M):M32-M35. 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. A diagnosis of anemia can mean youre low on iron. If a doctor has noted that you have polychromasia, there are several underlying conditions that are most likely the cause. All Rights Reserved. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Symptoms may include: Some symptoms are associated with specific underlying conditions, such as: Your doctor can diagnose anisopoikilocytosis using a peripheral blood smear. Treatment during pregnancy It's possible to have a successful pregnancy if you have antiphospholipid syndrome, especially with treatment. All polychromatophilic cells are reticulocytes, however, not all reticulocytes are polychromatophilic. (2015). However, the underlying conditions causing polychromasia can cause a variety of different symptoms. Am J Clin Nutr. This may lead to polychromasia when your blood is retested. Polychromasia is usually a sign of bone marrow stress as well as immature red blood cells. In addition, when any type of cancer has spread across the body, it can cause further destruction of RBCs. Most cases of polyhydramnios are mild and result from a gradual buildup of amniotic fluid during the second half of pregnancy. Philadelphia, Pa.: Saunders Elsevier 2017. https://www.clinicalkey.com. An obvious example of this is loss of blood from bleeding, which can cause severe anemia. RDW as differential parameter between microcytic anemias in pure and concomitant forms. Your comment will be reviewed and published at the journal's discretion. An overactive spleen, which is the organ responsible for destroying red blood cells, Medicines, including acetaminophen, antimalarial medicine, penicillin, and sulfa medications, Treatment to make your immune system stronger, Medicine to make your immune system weaker. People with myelodysplastic syndrome may need a bone marrow transplant. Anisocytosis is most commonly a result of another condition called anemia. For this test, a small drop of your blood is placed on a glass microscope slide and treated with a stain. Which diseases cause polychromasia? However, you can experience symptoms from the underlying condition causing it. (n.d.). Red blood cells can be released prematurely by a number of mechanisms. You can learn more about how we ensure our content is accurate and current by reading our. Our website services, content, and products are for informational purposes only. You can learn more about how we ensure our content is accurate and current by reading our. Braunstein EM. These cells are likely reticulocytes, which are immature non-nucleated red cells which have only just extruded their nuclei. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. i misspelled a term. If you have polychromasia, its important to meet with a doctor to diagnose the underlying condition and discuss treatment options. Language links are at the top of the page across from the title. Anemia during pregnancy. is this finding indicative of cancer? Friel LA. In this procedure, excess iron is removed from the blood following a blood transfusion. For these, please consult a doctor (virtually or in person). Theyre associated with rare inherited conditions as well as. This means anisopoikilocytosis can occur in the following conditions: There are no symptoms of anisopoikilocytosis. 1, 2 If Certain blood cancers, such as leukemia, start at the bone marrow and can greatly influence RBC production. Most women who have essential thrombocythemia have normal, healthy pregnancies. Please check for further notifications by email. She holds a Bachelor of Arts in journalism from Boston University, Copyright 2023 Leaf Group Ltd., all rights reserved. Typically, red blood cells turn a salmon pink color when stained. Low ferritin levels suggest iron deficiency. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Treatment will depend on the underlying condition thats causing anisopoikilocytosis. Causes of polychromasia A 49-year-old female asked: My recent blood smear showed slight "polychromasia"; cbc is normal except: low granulocytes & high lymphocytes. If the underlying cause is resulting in severe anemia, you might need a blood transfusion. ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C96206, labtestsonline.org/understanding/analytes/blood-smear/tab/test/, rarediseases.info.nih.gov/diseases/6639/hereditary-spherocytosis, ghr.nlm.nih.gov/condition/hereditary-spherocytosis#, nhlbi.nih.gov/health/health-topics/topics/anemia/treatment, mayoclinic.org/diseases-conditions/thalassemia/symptoms-causes/syc-20354995, mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360, ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C96207, sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/poikilocytosis, my.clevelandclinic.org/health/articles/thalassemias, nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia, 9 Signs and Symptoms of Vitamin B12 Deficiency. All rights reserved. Gabbe SG, et al. Polyhydramnios (too much amniotic fluid). 2016;43(4):527-542. doi:10.1016/j.pop.2016.07.006. There are other conditions that can cause destruction of RBCs without loss of blood, which is known as hemolytic anemia. information is beneficial, we may combine your email and website usage information with This color is seen because of the ribosomes still left on the immature blood cells, which are not found on mature red blood cells. However, ferritin is also an acute phase reactant and can be elevated with liver disease, malignancy, and chronic renal disease.18 Iron deficiency anemia is likely if the ferritin level is less than 15 ng per mL (15 mcg per L) in an otherwise healthy person, or less than 50 ng mL (50 mcg per L) in a person with an underlying source of chronic inflammation. Other causes include anemia of chronic disease, lead toxicity, sideroblastic anemia, and thalassemia trait.57 Table 2 presents the differential diagnosis of microcytosis.2,5,6, The diagnosis of iron deficiency anemia warrants additional evaluation for an underlying cause. T. TwinMama2o18. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. The condition is defined as a mean corpuscular volume of less than 80. Polychromasia, as well as the specific blood disorders that cause it, can be diagnosed via a blood smear test. Your red blood cells are the cells in your blood that carry oxygen to the rest of your body. Polychromasia neonate. "Development of Yolk Sac and Chorionic Cavity." Heavy alcohol drinking is known to further aggravate anemia. The most common cause of widespread bone marrow damage is infiltration by malignant (cancer) cells, either from the marrow itself (leukemia) or as the result of metastasis from other tissue. Hemoglobin electrophoresis may be considered earlier in the evaluation of children and young adults with microcytosis, in whom beta-thalassemia trait is more common. Severe cases may require treatment. During this test, a doctor spreads a thin layer of blood on a microscope slide. The earlier that polyhydramnios occurs in pregnancy and the greater the amount of excess amniotic fluid, the higher the risk of complications. With standard stains, they have a classic blue-gray appearance that results from the residual RNA in the cells. These cells are often shades of grayish-blue. In practice, it means that some of the red cells stain shades of bluish grey (Fig. Also found on this blood smear are several stomatocytes. If youre pregnant and have anisocytosis, your doctor will likely want to run other tests to see if you have anemia and begin treating it right away. Up to the first 60 days of life, the yolk sac is the main source of hematopoiesis. This content does not have an Arabic version. Accessed Oct. 1, 2017. Nutritional deficiency is the most common source of iron deficiency anemia in children,2,8 and menstrual blood loss is the most common source in menstruating women.9 Iron deficiency anemia in adult men and nonmenstruating women warrants further gastrointestinal investigation for occult blood loss, including evaluation for gastrointestinal malignancy.5,9. Many Blood Work images are provided by the ASH IMAGE BANK, a reference and teaching tool that is continually updated with new atlas images and images of case studies. Schrier SL. American Society of Hematology: "Blood Basics. Another cause of anemia is the increased loss or destruction of RBCs 1. A hormone called erythropoietin (EPO), produced by the kidneys, controls the rate of RBC production and release from the bone marrow. The most common cause of bone marrow damage is penetration by cancer cells, either from the bone marrow itself or as a consequence of metastasis from another part of the body. :) thanks. Your doctor may also ask you about your familys medical history. If you're diagnosed with polyhydramnios, your health care provider will carefully monitor your pregnancy to help prevent complications. Cells that have too much RNA are immature because they were released too soon from your bone marrow.. Poikilocytosis generally refers to an . 2023 Healthline Media LLC. Let's look at why and how to get support to stop drinking: While not as serious as other causes of chest pain, anemia-related chest pain can be a sign that your current treatment plan isn't working. J Nutr. Polychromasia refers to the light blue color of immature RBCs (caused by residual RNA). See permissionsforcopyrightquestions and/or permission requests. They also carry carbon dioxide from your body back to your lungs so that it can be exhaled during breathing. Polychromasia & anisocytosis--are they bad? [1] The young cells will generally stain gray or blue in the cytoplasm. Mild polyhydramnios may go away on its own. Blood. Based in Los Angeles, Marie Miller worked 15 years as a newspaper reporter in New Jersey and California. Depending on the cause, treatment may include: Adewoyin, A., Adeyemi, O., Davies, N., and Ogbenna, A. Enthrocyte, IntechOpen, 2019. Blood cell morphology in health and disease. Ferritin and transferrin saturation levels and TIBC are useful in differentiating iron deficiency anemia and anemia of chronic disease when the serum iron level is decreased. privacy practices. Poikilocytosis means that there are red blood cells of varying shapes on your blood smear. Since the only function of a mature RBC is to carry oxygen, normally when an RBC is released from the bone marrow, the nucleus and ribosomes are absent. Dr. Gurmukh Singh answered Therefore, its helpful to first break down the causes of these two conditions individually. Anemia at older age: etiologies, clinical implications, and management. Polychromasia is the presentation of multicolored red blood cells in a blood smear test. Treatment usually involves heparin or heparin with aspirin. Severe polyhydramnios may cause: Your health care provider may also suspect polyhydramnios if your uterus is excessively enlarged and he or she has trouble feeling the baby. What does it mean for a blood smear to show moderate polychromasia and moderate schistocytes? doi.10.1093/jn/nxz307. See additional information. Conditions that affect RBC turnover are generally the root cause of polychromasia. The mismatch occurs from inadequate dietary intake or increased needs, which usually cause only mild anemia, or from blood loss or malabsorption, which can lead to more significant anemia. Copyright 2023 American Academy of Family Physicians. The condition is defined as a mean corpuscular volume of less than 80 m3 (80 fL) in adults and is often associated with anemia.1 Normal mean corpuscular volume and hemoglobin levels vary during childhood, and normal hemoglobin levels can vary based on factors such as ethnicity, tobacco use, and altitude 2,3 (Table 12,4 ). Her articles have appeared in the Asbury Park Press, the Star Ledger and the Del Mar Sun. Prim Care. American Society of Hematology. [6] The absolute number of reticulocytes is referred to as the reticulocyte index and is calculated by adjusting the reticulocyte percentage by the ratio of observed hematocrit to expected hematocrit to get the 'corrected' reticulocyte count. Peripheral blood film - a review. 2023 Healthline Media LLC. Bleyl, Steven B., Philip R. Brauer, and Philippa H. Francis-West. Polychromasia is caused when immature RBCs, called reticulocytes, are released prematurely from bone marrow. Once a presumptive diagnosis of iron deficiency anemia has been made, an underlying source for the deficiency should be determined. Last medically reviewed on December 20, 2019. This page was last edited on 7 March 2023, at 22:01. Mayo Clinic does not endorse companies or products. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. In some cases, radiation therapy can cause changes in the way blood cells look. With acquired hemolytic anemia, your body produces normal red blood cells, but they are destroyed too quickly.