Introduction: Normoblastemia is the presence of nucleated RBCs (nRBCs) in the peripheral blood. It signifies bone marrow damage or stress and potentially serious underlying disease. Various infiltrating & non-infiltrating conditions present with normoblastemia ranging from infections, sepsis, haemorrhage, haemolysis, anemias to leukemias, lymphomas & metastases.
Aims and Objectives: 1. To study the distribution of various conditions presenting with normoblastemia in different age groups and sex. 2. To categorize the spectrum of conditions presenting with normoblastemia into non-infiltrating and infiltrating conditions based on the mechanisms involved.
Materials and Methods: A total of 100 adult patients presenting with normoblastemia were studied from June 2018 to December 2018. The patient’s medical history, clinical and hematological findings along with the peripheral smear examination to look for the presence of normoblastemia were evaluated. Bone marrow study was done wherever required.
Results: A total of 100 adult patients were included. 26% cases were between the age group of 21-30 years, thus constituting the largest group. 52% were males and 48% were females. The spectrum of conditions presenting with normoblastemia were categorized into non-infiltrating and infiltrating cases. Majority of the cases were non-infiltrating (72%) as compared to that of infiltrating cases (28%). The various mechanisms involved in the non-infiltrating conditions were hyposplenism, anemia and compensatory erythropoiesis, hypoxia and other miscellaneous causes. Iron deficiency anemias (23/72) were the highest followed by megaloblastic anemias (22/72) and sepsis (6/72). Among the infiltrating conditions, highest cases were chronic myeloid leukemias (9/28) followed by acute myeloid leukemias (6/28).
Conclusion: Normoblastemia offers an invaluable insight into disease processes. Its presence may indicate that a bone marrow examination is necessary to rule out hematologic malignant neoplasms or unsuspected blood disorders. This study emphasizes on the importance of finding even single nRBC that may lead to more timely medical intervention, thus increasing the chance of a positive outcome.