Few
normoblasts were seen in HbSS, but seen occasionally in HbSA.
Clusters of
normoblasts (extramedullary hematopoiesis) are commonly seen, as in fetal liver.
Cellularity : Low cellularity M: E ratio : Increased 7:1 Erythroid Series : Erythroid series hypoplasia, few colonies of
normoblasts Myeloid Series : Few granulocytes, few myelocytes, few metamyelocytes.
The bone marrow aspiration revealed bi- and tri-nucleated
normoblasts indicating erythroid hyperactivity and dyserythropoiesis with increased histiocytes without any evidence of hemophagocytosis.
Ehrlich distinguished 3 types of granulated white blood cells, as well as
normoblasts, megaloblasts, and leukemic cells.
The peripheral blood smear films for blood cells and parasites had significant polychromasia and anisocytosis and presence of
normoblasts but there were no plasmodia and microfilaria.
The possible explanations of anemia are intramedullary destruction of
normoblasts with Rh antibodies and low erythropoietin levels due to suppression of the bone marrow by IUT (1), (6), (9).
The differential on 500 cells revealed the following values: 0.01 myeloblasts; 0.01 promyelocytes; 0.15 myelocytes; 0.28 metamyelocytes; 0.40 granulocytes; 0.02 eosinophils; 0.01 basophils; 0.01 lymphocytes; 0.01 monocytes; and 0.09
normoblasts. The myeloid-erythroid ratio was 9.8:1.
The multivariate statistic is far more sensitive than histogram analysis to the presence of circulating
normoblasts, for instance, and has flagged such specimens almost unerringly.
All areas with terminal villous capillaries were examined at 40x magnification until either 3 fields containing at least 2 unequivocal
normoblasts in a single terminal villus were seen (increased NRBC) or the scan was completed.