A 29 year old Caucasian female came to the Emergency Room after a sports injury to her arm. The physician noted that she was pallor, slightly jaundice, and had scleral icterus. Physical exam showed no broken or fractured bones to her arm, just a 4.0 x 6.5 cm reddish to bluish bruising tender to the touch. Breathing was normal. No rib fractures were noted. Her spleen was palpable 4.0 cm below her left intercostal margin. The patient gave history of her own mother always looking pale and slightly yellowish and even her 7 year old son sometimes appearing yellowish in the morning. The patient attributed the color of her son to the color of his bedroom in the morning light. Because he never looked this way coming home from school.

Blood work was done and the results follow:

RBC 2.7 x 1012/L (low)

HgB 10.5 g/dL (low)

HCT 29.3 % (low)

MCV 87 fL (normal)

MCH 29.5 pg (normal)

WBC 6.5 x 109 /L (normal)

(47% neutrophils)

Platelets 385 x 109 /L (normal)

Even though her RBCs were normochromic, the cells demonstrated: anisocytosis, spherocytosis, and burr cell forms. The RBCs were noted to be normocytic and normochromic. The platelets were also noted to be normal.

From the above data, how would you expect the patient's recticulocyte count to be?

- elevated

- not elevated

- not enough data

- decreased