A patient's peripheral smear reveals numerous NRBCs, marked variation of red cell morphology, and pronounced polychromasia. What other CBC parameter may be anticipated?

The presence of numerous nucleated red blood cells (NRBCs), marked variation in red cell morphology, and pronounced polychromasia in a peripheral smear indicates a response to anemia or stress on the bone marrow, often seen in conditions such as hemolytic anemia or acute blood loss.

In this scenario, it is anticipated that the mean corpuscular volume (MCV) would be increased. This increase is likely due to the presence of younger, larger red blood cells being released into circulation as the marrow responds to the increased demand for erythrocytes. These reticulocytes, which are not yet fully mature red blood cells, are typically larger than mature erythrocytes and contribute to an overall increase in MCV. Thus, the combination of these findings aligns with the expectation of an increased average size of red blood cells being produced in response to an ongoing clinical issue.

In contrast, reduced platelets, increased mean corpuscular hemoglobin concentration (MCHC), or decreased red-cell distribution width (RDW) would not align with the clinical presentation of pronounced polychromasia and variation in morphology. Understanding these relationships helps delineate the underlying pathology affecting the patient's hematological profile.