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Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
After maturation in the bone marrow, young red cells (reticulocytes) pass into the bloodstream. The reticulocyte count (normally approximately 1% of the total red cells) represents new red cell production and is a useful measure of how effective the bone marrow is at producing new cells (for the normal range, see Table 15.1). In disease states such as haemolytic anaemia, a very high reticulocyte count would be expected as the bone marrow tries to compensate for the cells being lost. After about 120 days in the circulation, the cell is recycled by macrophages in the spleen. Premature destruction of red cells is called haemolysis.
Maternal Anemia
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Ashley E. Benson, Marcela C. Smid
If high reticulocyte counts (≥3), then anemia may be secondary to hemolysis or blood loss. Consider (1) peripheral blood smear and haptoglobin (decreased), (2) direct Coombs (suggests autoimmune hemolytic anemia), (3) Hgb electrophoresis to rule out SS or SC disease, and (4) hemoccult or other tests if other sources of blood loss are suggested by history.
Long-Term Glucose Infusions in the Treatment of Fetal Growth Retardation
Published in Asim Kurjak, John M. Beazley, Fetal Growth Retardation: Diagnosis and Treatment, 2020
The titre was significantly greater (p <0.01) in the untreated SFD newborns than in the treated ones (Figure 16) who had practically the same value as the control group. Similar results were found upon analyzing the reticulocyte count. The lower value in the treated SFD newborns can be considered as a sign of compensation of the chronic hypoxia.
Ultrastructural analysis of nucleated erythrocyte in patients with autoimmune hemolytic anemia (AIHA)
Published in Ultrastructural Pathology, 2023
Jing Liu, Shuxu Dong, Yongxin Ru
AIHA is usually characterized by the destruction of mature RBCs in PB and proliferation of erythroid precursors in BM, but rarely the presence of damaged nucleated erythrocytes. In this study, BM smears of patients with a clinically definitive diagnosis of AIHA showed notable erythroid hyperplasia, mainly polychromatic and orthochromatic normoblasts. Mature erythrocytes showed different sizes and included polychromatic erythrocytes, which was consistent with increased level of reticulocyte count. In addition, spherocytes were occasionally seen due to defective macrophage phagocytosis.8 They are fragile and easily destroyed as they pass through the spleen. The reticulocyte absolute count is a useful indicator for assessing BM response.9,10 The positive compensation of BM to AIHA (reticulocytosis) is the normal response to the destruction of RBCs.11,12 However, the phenomenon of reticulocytopenia may be detected in peripheral blood in cases of insufficient capacity of BM, probably induced by autoantibody attack of nucleated erythrocytes.13
The New Zealand white rabbit animal model of acute radiation syndrome: hematopoietic and coagulation-based parameters by radiation dose following supportive care
Published in International Journal of Radiation Biology, 2021
Andre Paredes, Matthew Lindeblad, Rachana Patil, Matthew D. Neal, Yuanfan Hong, Brett Smith, Joy P. Nanda, Vasileios Mousafeiris, John Moulder, Maarten C. Bosland, Alexander Lyubimov, Amelia Bartholomew
Reticulocyte counts (Figure 3(C,D)) of non-survivors were significantly higher (p = 0.007) than survivors at 1 h following radiation, with 8 and 10 Gy dose groups exhibiting higher increase compared to 7 Gy. On day 1, reticulocyte levels dropped consistently across all dose groups to nearly half of the baseline. On day 3, further decreases were observed for all three groups to approximately 4–8% of baseline values. By day 8, reticulocyte counts rebounded 100% above baseline for the 7 and 8 Gy dose groups whereas the 10 Gy dose group only increased to a mean of 37.7% of baseline. For the 7 and 8 Gy dose group, reticulocytes continued to increase, reaching approximately 4-fold increases from baseline on days 22 and 17, respectively. At day 30, reticulocyte counts were noted to have decreased to near baseline values. No animal in the 10 Gy group survived past day 12 and their reticulocyte counts were significantly lower (p < 0.001) than baseline at time of death. Interestingly, for those animals demonstrating mortality after 8 days in the 7 and 8 Gy dose groups, the reticulocyte counts were ∼50% below baseline. The 10 Gy group, demonstrated a more profound decrease to a mean of 8.4% of baseline values on day 3, suggesting a differential in the magnitude of effect on the bone marrow between the 7 and 8 Gy dose groups compared to the 10 Gy dose group.
Low- and intermediate-risk myelodysplastic syndrome with pure red cell aplasia
Published in Hematology, 2021
Huaquan Wang, Haiyue Niu, Tian Zhang, Limin Xing, Zonghong Shao, Rong Fu
Our study found that there were 6 low- and intermediate-risk MDS patients with PRCA, 1 male and 5 females, with a median age of 63.5 (50-75) years. It accounted for 7.7% (6/78) of all diagnosed PRCA cases and 1.67% (6/359) of diagnosed MDS cases during the same period. All patients had severe anemia and were red blood cell (RBC) transfusion dependence. The median RBC transfusion was 4 (2-8) U /8 weeks. The reticulocytes are severely reduced. The number of white blood cells and platelets were normal. The bone marrow erythroid precursors were severely reduced, with a median of 1.25 (0.5-2.0) %. Serum erythropoietin (EPO) and ferritin levels were significantly increased. One patient had a 5q- and 20q- chromosome karyotype, and one patient had a 20q-chromosome karyotype during follow-up, one patient had 1q21. TET2, GATA2, KRAS and DNMT3A mutations were found in the patients. None of the 6 patients was positive for STAT mutations. According to the WHO 2016 MDS diagnostic criteria, one patient was 5q syndrome, and five patients had MDS-MLD (Tables 1 and 2).