Simultaneous measurement of reticulocyte and red blood cell indices in healthy subjects and patients with microcytic and macrocytic anemia

Abstract

Using the new Bayer H*3 hematology analyzer (Leverkusen, Germany), we have determined red blood cell and reticulocyte indices in 64 healthy subjects, in patients with microcytosis due to iron deficiency (58 patients) and heterozygous beta-thalassemia (40 patients), and in patients with macrocytosis (28 patients). We found in all cases that reticulocytes were larger than mature red cells by 24% to 35%, with a hemoglobin concentration 16% to 25% lower and a similar hemoglobin content. The correlation between red cell and reticulocyte indices was strikingly tight (r = .928 for volume, r = .929 for hemoglobin concentration, r = .972 for hemoglobin content) in all four groups, regardless of red blood cell size. The ratio of reticulocyte to red blood cell mean corpuscolar volume (MCV ratio) was constantly above 1. Inversion of the MCV ratio was observed only in four patients. It was always abrupt and transitory and was associated with erythropoietic changes leading to the production of red blood cells of a different volume (treatment of megaloblastic anemia, functional iron deficiency, bone marrow transplantation). In two cases of marrow transplantation, reticulocyte volume fell during the aplastic phase after conditioning chemotherapy and then rapidly increased up to values higher than before; this production of macroreticulocytes was the earliest sign of engraftment.

Hemolytic anemia induced by ribavirin therapy in patients with chronic hepatitis C virus infection: Role of membrane oxidative damage

“…Erythrocyte and reticulocyte indices were studied with the Bayer H*3 analyzer (Miles, Diagnostic Division, Tarrytown, NY). 27,28 From the absolute reticulocyte count and CHr (Hb content of individual reticulocytes), the retHb was calculated, which expresses in grams per liter the Hb content of the reticulocyte pool. 27,28 By subtracting retHb from total Hb, the amount of Hb contained in the mature erythrocyte (RBCHb) can be calculated.…”

“…27,28 From the absolute reticulocyte count and CHr (Hb content of individual reticulocytes), the retHb was calculated, which expresses in grams per liter the Hb content of the reticulocyte pool. 27,28 By subtracting retHb from total Hb, the amount of Hb contained in the mature erythrocyte (RBCHb) can be calculated. The RBCHb/retHb ratio represents the ratio between Hb contained in the mature erythrocytes and that contained in reticulocytes, and was used to indirectly estimate the degree of reduction in erythrocyte survival.…”

Evaluation of reticulocyte parameters in iron deficiency, vitamin B12 deficiency and β‐thalassemia minor patients

“…The laser-based technology allows simultaneous measurement of volume and hemoglobin concentration in both mature red blood cells and reticulocytes. The reticulocyte hemoglobin content is a parameter obtained from direct measurements of reticulocyte volume and hemoglobin concentration (D'Onoforio et al, 1995).…”

Reticulocyte hemoglobin equivalent to detect thalassemia and thalassemic hemoglobin variants

“…Measurement of hemoglobin in reticulocytes has proved useful for the diagnosis and follow-up of IDA [11], while its use in hemoglobinopathies has been less extensively elaborated [12][13][14][15][16]. Reticulocyte hemoglobin is available on both Advia (reticulocyte hemoglobin content; CHr) [17][18][19] and on Sysmex (reticulocyte hemoglobin equivalent; Ret-He, formerly Ret-Y) [20][21][22][23][24].…”