About reticulocyte

Author: Xiangya Medical College of Central South University-Wang Xuemei

The development process of red blood cell system in bone marrow is pluripotent stem cells → pluripotent stem cells → primitive red blood cells → early erythrocytes → middle erythrocytes → late erythrocytes → reticulocytes → mature erythrocytes. Today we are going to talk about reticulocytes.

　

reticulocyte

Reticulocyte is a transitional cell from enucleated late erythrocytes to mature erythrocytes. It is named reticulocyte because of the remaining basophilic substances such as ribosomes and ribonucleic acid in its cytoplasm. After living staining with Brilliant Tar Blue or Neomethylene Blue, blue or blue-green reticular structure can be seen in its cytoplasm. This kind of cell belongs to immature red blood cells, which remain in the bone marrow for a certain period of time before being released into the blood stream. Therefore, the number of reticulocytes in bone marrow is not only higher than that in peripheral blood, but also naive, which is a sensitive index to judge the inhibition and recovery of hematopoietic function in bone marrow.

Clinical significance of reticulocyte parameters

Differential diagnosis of anemia

The combination of absolute reticulocyte count (RET﹟) and immature reticulocyte index (IFR) is helpful to judge the type of anemia.

Table 1. Differential diagnosis of anemia by RET combined with IRF [1-3]

Notes:

(1) The results only explain the experimental research samples;

(2) Immature reticulocyte index (IFR) is defined as the ratio of immature or immature reticulocytes to total reticulocytes. The closer to maturity, the lower the fluorescence intensity of reticulocytes, and the larger the volume of immature reticulocytes. According to their light scattering characteristics, they are mainly high and medium fluorescence reticulocytes with high fluorescence intensity and high residual RNA content.

Monitoring of radiotherapy and chemotherapy

The dynamic observation of reticulocyte can guide the clinical adjustment of treatment plan in time and avoid serious bone marrow suppression. In the process of cancer chemotherapy, 1RF is a very sensitive index to reflect bone marrow suppression and recovery. In the stage of complete bone marrow suppression, IRF can be reduced to zero. After receiving radiotherapy and chemotherapy, if bone marrow suppression occurs, the IFR will first decrease and then the reticulocyte value will decrease. If the bone marrow begins to recover after stopping radiotherapy and chemotherapy, IFR will also increase first, and then the reticulocyte value will increase. Immature reticulocyte (IRF) is an important sensitive index to evaluate the curative effect of anemia drugs, especially in chronic renal failure or acquired immunodeficiency disease.

Monitoring of bone marrow transplantation

The increase of peripheral blood granulocyte count is the basis for early monitoring after transplantation, but the absolute value of granulocyte may be affected by simultaneous infection and transplant rejection. In addition, preventive platelet transfusion will also affect the monitoring of platelet manufacturing ability in the early stage of transplantation. Therefore, both are not ideal. Reticulocyte parameter is an independent parameter to detect hematopoietic recovery of bone marrow, which is usually not related to transplantation complications.

Ret-he (reticulocyte hemoglobin)

It is used to diagnose iron metabolism disorder anemia and detect the state of iron storage in the body. This parameter is of great value for the diagnosis and treatment of anemia caused by functional iron deficiency, and can monitor the effect of EPO and iron treatment. Ret-He is decreased in functional iron deficiency caused by stored iron loss, which is a typical iron deficiency anemia and can be treated with iron agent (orally). When functional iron deficiency is accompanied by RET-He decline in iron-rich state, iron injection and EPO should be used for treatment.

references

Jia Lianling, Ou Hongling, Huan Wang, Zhao Haijiao, Li Meng, Wang Xinru. Diagnostic value of new reticulocyte parameters for anemia [J].

Xu Guizhu, Ronghua Qiu. Clinical significance of reticulocyte and red blood cell parameters in differential diagnosis of thalassemia and iron deficiency anemia in pregnant women [J].

Chen Min, Xiaowei Liu. Clinical value of reticulocyte parameters in diagnosis of anemia [J].

This article was originally written by the Voice of Inspection, please indicate the source.

Editor: Green is about to drip

Review: Chenchen