[Extreme increase in the blood erythroblast count in a patient with iron-deficiency anemia and asplenia].

Bone marrow stress can provoke the presence of high erythroblast count in peripheral blood of patients with splenectomy, but is very rare in patients with normal spleen. Hypoxia occurring in patients with severe ferropenic anaemia could originate the occasional presence of erythroblasts in peripheral blood. An associated pathology should be excluded if there is a high normoblast count. We present the case of a 40 years old woman with ferropenic anaemia and a very high normoblast count. Hyperplastic polips were found in the gastric tissue as the cause for her anaemia. The absence of spleen explained the presence of erytroblasts. Further studies excluded the possibility of hemoglobinopathy and bone marrow studies were normal. Treatment with iron was successfully in correcting the hemoglobin levels and the normoblasts disappeared from peripheral blood also. A careful examination of the peripheral blood film and, specially the presence of Howell-Jolly bodies is the cornerstone of the possible diagnosis confirmed with the appropriate radiological studies.