II. Physiology: Erythropoiesis (mature red cell development)

  1. See Bone Marrow (Erythroblast)
  2. Images
    1. HemeBloodCellOrigin.jpg
  3. Stimulation of RBC production
    1. Chronic Hypoxia (e.g. COPD, living at high altitude) stimulates renal erythropoetin release
    2. Erythropoetin stimulates RBC production in marrow
  4. Development in Marrow
    1. Proerythroblast is RBC stem cell in marrow (0.5 days)
    2. Basophilic Erythroblast (0.8 days)
      1. Nucleus shrinks, cytoplasm darkens with ribosomes
    3. Polychromatophilic erythroblast (1.3 days)
      1. Cell produces Hemoglobin
      2. Stains with basic and eosin stains
    4. Orthochromatic erythroblast (2.0 days)
      1. Cell appears more Eosinophilic
  5. Reticulocyte: Transition to Circulation
    1. Orthochromatic erythroblast sheds nucleus
    2. Marrow Reticulocyte spends 1.7 days in marrow
    3. Blood Reticulocyte spends 1.3 days in circulation
  6. Red Blood Cells in Circulation
    1. Mature Red Blood Cell (120 day life-span)

III. Findings: Normal Values (in 10^6/ul or 10^12/L) per age

  1. Age <1 month: 3.6 to 6.6
  2. Age 1-6 months: 2.7 to 5.4
  3. Age 0.5 - 6 years: 3.7 to 5.3
  4. Age 6-12 years: 4.0 to 5.2
  5. Female
    1. Age 12-18 years: 4.1 to 5.1
    2. Age >18 years: 3.8 to 5.2
  6. Male
    1. Age 12-18 years: 4.5 to 5.3
    2. Age >18 years: 4.4 to 5.9

IV. Findings: Increased Red Blood Cell Count

  1. Polycythemia Vera
  2. Tobacco Abuse
  3. Living at High altitude
  4. Renal Cell Carcinoma
  5. Cardiovascular disease
  6. Stress
  7. Dehydration
  8. Thalassemia Trait

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