Reticulocyte: Difference between revisions

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The name comes from a microscopic staining technique by which they were first characterized, in which parts of the ribosomes collect in a "reticulated" pattern. This collection is not the same as the [[endoplastic reticulum]].
The name comes from a microscopic staining technique by which they were first characterized, in which parts of the ribosomes collect in a "reticulated" pattern. This collection is not the same as the [[endoplastic reticulum]].
==Corrections for clinical utility==
==Corrections for clinical utility==
While the basic laboratory report on reticulocytes is their percentage relative to all erythrocytes, this measurement alone is misleading. It must be corrected both for the absolute number of erythrocytes including reticulocytes, <ref name=Harrison14>{{citation
| title = Harrison's Principles of Internal Medicine
| date = 14th Edition, 1998
| author = Fauci AS, ''et al.''
| publisher = McGraw-Hill
| isbn = 0070202915}}, p. 337}}</ref>
Absolute Reticulocyte Count = # or % retics * (Pt's Hct / Normal Hct)
and for the effect of [[erythropoetin]] released in anemia.
Reticulocyte Index = Absolute Retic Ct / Maturation Factor
{| class="wikitable"
'''Reticulocyte maturation factors'''
|-
! Hematocrit (Hct)
! Reticulocyte maturation factor
|-
| Hct ≥ 45%
| 1.0
|-
| 45% > Hct ≥ 35%
| 1.5
|-
| 25% > Hct ≥ 15%
| 2.0
|-
| 15% ≠> Hct
| 2.5
|}
In the presence of decreases in erythrocytes,
*Normal patients will respond to a Hct < 30% with a 2 to 3 increase in maturation factor
*Patients with severe hemolytic anemia can show 6-fold increase
*When bone marrow disease or deficiency of erythrocyte precursors are present, the maturation factor is less than 2
==References==
{{reflist}}

Revision as of 14:10, 12 December 2009

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A reticulocyte is an immature erythrocyte (i.e., red blood cell), which are primarily present in bone marrow but may circulate in blood. When reticulocytes circulate in a higher than normal percentage of erythrocytes, it suggests that erythropoiesis is being hyperactive. When the reticulocyte percentage is zero to low in the presence of anemia, it suggests depressed erthryopoiesis.

The name comes from a microscopic staining technique by which they were first characterized, in which parts of the ribosomes collect in a "reticulated" pattern. This collection is not the same as the endoplastic reticulum.

Corrections for clinical utility

While the basic laboratory report on reticulocytes is their percentage relative to all erythrocytes, this measurement alone is misleading. It must be corrected both for the absolute number of erythrocytes including reticulocytes, [1]

Absolute Reticulocyte Count = # or % retics * (Pt's Hct / Normal Hct)

and for the effect of erythropoetin released in anemia.

Reticulocyte Index = Absolute Retic Ct / Maturation Factor


Reticulocyte maturation factors
Hematocrit (Hct) Reticulocyte maturation factor
Hct ≥ 45% 1.0
45% > Hct ≥ 35% 1.5
25% > Hct ≥ 15% 2.0
15% ≠> Hct 2.5

In the presence of decreases in erythrocytes,

  • Normal patients will respond to a Hct < 30% with a 2 to 3 increase in maturation factor
  • Patients with severe hemolytic anemia can show 6-fold increase
  • When bone marrow disease or deficiency of erythrocyte precursors are present, the maturation factor is less than 2

References

  1. Fauci AS, et al. (14th Edition, 1998), Harrison's Principles of Internal Medicine, McGraw-Hill, ISBN 0070202915, p. 337}}