Die Bestimmung der Retikulozytenzahl: Eine alte Methode gewinnt neue Bedeutung

Abstract

In clinical practice, the reticulocyte count is the most useful method to estimate red cell life span and red cell production. However, experience of hematologists as well as surveys have shown that counting of reticulocytes is often neglected in the diagnostic work-up of unclassified anemias, and many physicians have difficulties in interpreting the results. Formerly, this was partly due to the low precision of manual counts. Today, this method is largely replaced by flow cytometry, available in almost all larger systems for automated blood count analysis, at low costs and sufficient analytic precision. Interpretation is supported by calculated parameters such as the Reticulocyte Production Index. Here, the authors discuss the limits of the analytic methods and the problems of interpretation in the context of the laboratory profile and the clinical setting.

Eisen bei der Behandlung der renalen Anämie

“…Bei CKD-Patienten schließt ein negativer iFOBT ein gastrointestinales Malignom praktisch aus 19 . Retikulozyten werden unter Anämie frühzeitig vom Knochenmark ins periphere Blut abgegeben, wo sie falsch hoch gemessen werden 20 . Die absoluten Retikulozyten müssen daher in Relation zum Hb-Wert bzw.…”

“…Eine obere und/oder untere gastrointestinale Endoskopie kann sinnvoll sein (Nutzen-Risiko-Abwägung). CKD-Patienten haben ein erhöhtes Risiko für gastrointestinale Blutung, für einen dadurch bedingten Tod 21 , für gastrointestinale Malignome und für Endoskopiekomplikationen 20 . Die Inzidenz von gastrointestinalen Malignomen ist erhöht bei Herzinsuffizienzpatienten mit Hb von < 12 g/dl und Ferritin von < 100 ng/ml oder Ferritin von 100–300 ng/ml plus TSAT von < 20 % (6 % vs. 1,5 % mit Anämie ohne „Fe-Mangel“ 22 ).…”

Anaemia in South American camelids – an overview of clinical and laboratory diagnostics

“…These stains form precipitates with the ribonucleic acid, that is still present in high concentrations in the young cells and which appears as a stained reticular structure in light microscopy, the Substantia granulofilamentosa (Fig. 4 ) (Heimpel et al 2010 ; Papasouliotis and Murphy 2021 ). Although reticulocytes can also be determined using automated methods, it is not yet known how accurate these examinations are for reticulocytes in camelids.…”

Anaemia in the Elderly IBD Patient

“…The absolute reticulocyte count, on the other hand, is a gauge for effective erythrocyte production by the bone marrow [36]. Therefore, anaemia can be effectively classified using a combination of MCV and reticulocytes (Table 4).…”