Normoblastemia in Neonates and Infants
Normoblastemia in neonates or infants is defined as the presence of higher than the normally expected number of nRBC’s in the blood or the presence of any nRBC beyond the age of approximately 1 week after full term normal birth. The significance of normoblastemia should be considered in the context of the clinical setting in which it is discovered. Interpretation of normoblastemia should be made with factors including age of the patient, number and the spectrum of maturity of the nucleated red cells, presence or absence of reticulocytes, other red cell abnormalities, circulating immature granulocytes or bizarre platelets, hyposplenism or asplenism. The presence of normoblastemia indicates intravascular haemopoiesis or disruption of marrow structure or the inability of the bone marrow’s screening mechanism to prevent their passage into the circulation. Correction of WBC count with even 1 nRBC/100 WBC’s should be done, thus alerting the clinicians of the significance of unexplained normoblastemia.