From the Research
No, prednisone itself does not typically cause nucleated red blood cells (NRBCs) to appear in peripheral blood smears. Nucleated red cells are immature red blood cells that are normally only found in bone marrow and are not typically present in the peripheral blood of healthy adults. Prednisone, a corticosteroid medication, primarily affects white blood cells and can cause an increase in their numbers (leukocytosis) 1. It does not directly lead to the release of immature red blood cells into the circulation. However, it's essential to note that patients taking prednisone often have underlying medical conditions that could potentially cause NRBCs to appear in a peripheral smear. These conditions might include severe anemia, hematological disorders, or certain cancers. If NRBCs are observed in a peripheral smear of a patient taking prednisone, it's more likely due to the underlying condition being treated rather than a direct effect of the medication. Any observation of NRBCs in a peripheral smear should prompt further investigation to determine the underlying cause, as their presence is associated with a high risk of mortality and poor prognosis, especially in critically ill patients 2, 3. The presence of NRBCs may serve as a valuable clue about a possible underlying malignancy or other severe diseases, and their detection can aid in the early identification of patients at high risk 4, 5. Therefore, the presence of NRBCs in a peripheral blood smear should be thoroughly investigated to determine the underlying cause and provide appropriate management.
Some key points to consider:
- NRBCs are not normally found in the peripheral blood of healthy adults
- Prednisone primarily affects white blood cells, not red blood cells
- Underlying medical conditions, such as severe anemia or hematological disorders, may cause NRBCs to appear in a peripheral smear
- The presence of NRBCs is associated with a high risk of mortality and poor prognosis
- Further investigation is necessary to determine the underlying cause of NRBCs in a peripheral smear.