Did your blood test say 'Polychromasia'? Let's see what it is! (Polychromasia)

When you do a blood test, sometimes we see unfamiliar words in the report, right? Maybe your report also had the word Polychromasia or Polychromatophilia. It can be a little scary when you see it. But don't worry, we will talk about this simply today.

What is Polychromasia?

Simply put, Polychromasia means that your red blood cells have different colors. This is seen when a sample of your blood is taken, placed on a glass slide, stained with a special dye, and looked at under a microscope. We call this test Peripheral Blood Smear (PBS).

Normally, healthy, well-developed red blood cells appear pink in PBS. However, if Polychromasia is present, among these pink cells, you can see a few cells that look blue, bluish-gray, or purple . These differently colored cells are often immature red blood cells . In medicine, we call these immature red blood cells Reticulocytes.

Polychromasia actually means that your bone marrow is releasing new, immature red blood cells (Reticulocytes) into your blood too quickly. You know, bone marrow is the soft, spongy part of your body that's inside the big bones. All the red blood cells, white blood cells, and platelets in your blood are made in the bone marrow. It's like a factory.

Why do these red blood cells look blue?

Now you might be wondering why these immature red blood cells (Reticulocytes) look blue. The reason is that these Reticulocytes contain genetic material called RNA. When they react with the PBS stain, this RNA turns blue. This RNA is like a temporary program in the cell. When a Reticulocyte matures and becomes a full-fledged red blood cell, this RNA disappears.

It is important to identify these Reticulocytes in a PBS. Because, Reticulocytes are a group of cells that cannot carry oxygen as efficiently as fully mature red blood cells. The main function of red blood cells is to carry oxygen to every cell in our body. So, having too many immature cells means that that function is not being performed properly.

What are the causes of Polychromasia?

Polychromasia can be a symptom of an underlying medical condition. This condition causes your bone marrow to release immature red blood cells into your bloodstream too quickly. This usually happens when the number of mature red blood cells in your blood decreases. The body tries to compensate by quickly releasing reticulocytes from your bone marrow into your bloodstream.

Here are some reasons why you may see Polychromasia:

• Hemolytic Anemia: This is a blood disorder. This is where red blood cells are destroyed prematurely. Sometimes this destruction can occur at a rate that the body cannot make new red blood cells. This results in anemia. Hemolytic anemia can also be caused by hereditary conditions such as Paroxysmal Nocturnal Hemoglobinuria (PNH), Thalassemia, and Sickle Cell Disease. It can also be caused by certain infections and certain medications.
• Severe blood loss: When there is excessive bleeding, either internally or externally, the bone marrow is stimulated to increase the production of red blood cells. Reticulocytes are then released into the blood to replace the lost red blood cells. Imagine, if you lose a lot of blood in a major accident, this can happen.
• Cancer: Some types of cancer can spread to the bone marrow and interfere with red blood cell production, or can push immature blood cells into the bloodstream.
• Pregnancy: It is common for the number of Reticulocytes in the blood to be slightly higher than normal during pregnancy. In most cases, this is not a cause for concern.
• Living at high altitudes: Oxygen levels are low at high altitudes. The body can adapt to the lack of oxygen by increasing the production of red blood cells and releasing reticulocytes into the blood.

Nutrients that increase red blood cells

Sometimes, when you start taking vitamins and supplements that are needed to make healthy red blood cells, you may see Polychromasia'' on your blood report. This means that your body is reacting. If you are not getting enough of these nutrients from the foods you eat, your doctor may recommend:

• Vitamin B12 (Vitamin B12)
• Folic acid (Folic acid)
• Iron

These nutrients are essential for the production of red blood cells. For example, iron helps make hemoglobin, the oxygen-carrying protein in red blood cells. Vitamin B12 and folic acid are essential for the division and maturation of red blood cells.

What are the symptoms of Polychromasia?

There are no specific symptoms for Polychromasia. However, you may experience symptoms that are caused by an underlying condition, such as anemia, that causes Polychromasia.

These are the most common symptoms of anemia:

• Pale skin
• Headache
• Weakness or fatigue
• Difficulty breathing (Dyspnea)
• Rapid heartbeat (Tachycardia)
• Dizziness or lightheadedness
• Low blood pressure (Hypotension)
• Yellowing of the skin or whites of the eyes (Jaundice) - This is especially seen in Hemolytic Anemia.
• Spleen (Splenomegaly) or Liver (Hepatomegaly) enlargement

Sometimes there may be no symptoms at all. It all depends on the underlying condition that caused the polychromasia and its severity.

How to recognize Polychromasia?

Doctors can tell if you have polychromasia from the results of a PBS (peripheral blood smear) test. This will show dark blue or blue-gray red blood cells (called reticulocytes) in your blood sample, along with the normal pink mature red blood cells.

Remember, Polychromasia is something that is seen in a blood test, and is not a diagnosis in itself.

Therefore, your doctor may order additional tests to help determine the cause of your condition. He or she will ask you about your symptoms, your medical history, and any medications you take. They may also perform a physical exam to check for signs of hemolytic anemia (such as an enlarged spleen or liver). The specific tests you will have will depend on the cause that is thought to be affecting the release of reticulocytes from your bone marrow.

How is Polychromasia treated?

Treatment depends on the cause of your polychromasia. If the cause is mild anemia and you don't have any major symptoms, you may not need treatment. However, if you have a serious underlying condition that is causing your polychromasia, your doctor will recommend appropriate treatment.

These can be used as treatments:

• Blood transfusion: In some hereditary conditions such as Sickle Cell Disease or in cases of severe bleeding.
• Corticosteroids: In conditions like Autoimmune Hemolytic Anemia, where your immune system destroys your own red blood cells.
• Immunosuppressants: These may be given when the immune system is destroying red blood cells and treatments such as corticosteroids are not effective.

If polychromasia is caused by a bacterial, viral, or parasitic infection, specific medications may be needed for that infection. If the condition is caused by a medication, you may need to stop taking that medication or switch to a different medication. However, never stop taking any medication without your doctor's advice. Your doctor will guide you carefully.

Should you be afraid of Polychromasia?

Not necessarily. Polychromasia can be a sign of a blood disorder that needs treatment, or it can be something completely harmless. For example, if you're pregnant or have just started taking iron supplements, this can be normal.

Your doctor will tell you about these results and explain whether they are something to be concerned about or whether further testing is needed.

When should I see a doctor?

If you have symptoms of anemia, such as fatigue, paleness, and shortness of breath, make an appointment to see a doctor. In the meantime, don't skip your annual check-ups. Your doctor may monitor your blood cells by doing tests like a PBS if needed.

Blood test reports can provide a lot of information about your general health. They can also help you identify blood conditions that may require treatment early.