Polychromasia: meaning, causes, and treatment

‘Poly’ = many and ‘chromasia’ = color. Polychromasia means multi coloured red blood cells in your blood.

This condition can occur because of many causes. Your doctor comes to know about it with a lab test.

How red cells are formed?

Red blood cells constitutes major part of your blood volume.

These cells contain haemoglobin. It is an iron compound with globuline protein.

It carries oxygen from lung and releases to various organs.

Red blood cells are formed in various organs in various stage of life.

Red cells are formed in the liver at a young age and bone marrow takes over as you grow older.

A hormone produced by kidney called erythropoietin is needed for this process to get stimulated.

They are formed from stem cells undergoing development in various stages.

Younger red blood cells produced in bone marrow undergo development there. They are released to blood when they are mature enough.

How are red cells examined?

Red cells are examined in the lab under a microscope. For this test a few drops of your blood are taken on a glass slide. It is a peripheral blood smear exam. Then special stains are used for colouring them.

With these special stains the nucleons are coloured with different colours and cytoplasm with different ones.

If the cytoplasm contains RNA or nucleic acid it stains with bluish grey colour. 

Cytoplasm without nucleic acid stains pink or orange or no colour.

Normal RBC look pink or orange or no colour.

Young RBC having nucleic acid RNA in their cytoplasm appear bluish gray or purple coloured.

With this test RBC size, morphology and indices can be examined. This test also detects other cells like WBC and platelets. It can detect parasites like malaria parasites as well.

What is polychromasia?

Polychromasia is not disease itself. It is an indication of various diseases.

It simply means on peripheral blood smear you have RBCs or many colours.

It means you have premature RBCs in your blood. Premature RBCs are called reticulocytes. 

It essentially indicates for some reason young RBCs are released into blood before they are mature.

Various conditions we are going to discuss below lead to this finding.

What is the significance of polychromasia?

Polychromasia indicates presence of immature younger cells in your blood. They are present along with normal or abnormal mature RBCs.

Polychromasia is a lab finding that is seen in various conditions. 

This condition occurs because of increased rate of speed of RBC production, or because of faulty RBC factory that is bone marrow.

So polychromasia is a finding that helps to detect conditions or diseases causing a fault in these mechanisms.

Which diseases cause polychromasia?

The diseases which cause increased formation of RBCs or the diseases in which the function of bone marrow is damaged can lead to finding of polychromasia.

These diseases include:

  • Hemolytic diseases in which RBC are destroyed fastly like sickle cell anaemia or increased function of the spleen.
  • Diseases in which there is faulty formation of RBCs called ineffective erythropoiesis like thalassemia.
  • Hypersplenism: in which RBCs are destroyed in the spleen because of excess abnormal function of the spleen.
  • Tumours of bone marrow in which the bone marrow undergoes abnormalities like myelodysplastic metaplasia.
  • PNH is paroxysmal nocturnal haemoglobinuria. In this condition there is hemolysis and blood clots formation.
  • Bleeding because of some injury or bleeding disorder may increase blood cell formation.
  • Radiation exposure may cause polychromasia.

What are possible symptoms with these conditions?

Polychromasia is a lab finding associated with multiple diseases. 

The symptoms vary depending upon the underlying disease causing this condition.

Common symptoms associated with this lab findings are:

  • Fatigue.
  • Bone pain.
  • Easy tendency of bone fractures.
  • Rapid heart rate.
  • Difficulty in breathing.
  • Loss of appetite.
  • Limb pain.
  • Increased size of abdomen because of enlarged liver and spleen.
  • Darkening of skin and face.
  • Growth failure in children.
  • Malnutrition.
  • Stroke and paralysis.

What is treatment for polychromasia?

Treatment for this condition depends upon the underlying cause. The underlying causes may need specific treatment aimed to cure them.

  • Blood transfusion is needed for conditions causing severe anaemia like thalassemia and sickle cell anaemia.
  • Hypersplenism may need to be treated by splenectomy a surgical procedure in which spleen is removed.
  • Bone marrow transplant may be needed to cure conditions like thalassemia, sickle cell anaemia and some cancers.
  • Treatment with antibodies like rituximab may be needed for treatment of some cancers.


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