Lab 1 Reticulocyte Count PDF - Jabir Ibn Hayyan Medical University

Jabir Ibn Hayyan Medical University Faculty of Medicine Practical Blood Physiology 2nd year 2024-2025 Lab (1) Reticulocytes count Lecturer: Hematologist/ Hussein...

Jabir Ibn Hayyan Medical University Faculty of Medicine Practical Blood Physiology 2nd year 2024-2025 Lab (1) Reticulocytes count Lecturer: Hematologist/ Hussein R. Alasady  Blood Physiology Lab.1 By: Hussein R. Alasady ____________________________________________________________________________ Reticulocyte Count The reticulocyte has residual RNA and mitochondria in the cytoplasm, which give the young cell a bluish tinge with Romanowsky stains. About 80% of the cell’s hemoglobin is made during the normoblast stages with the remaining 20% made during the reticulocyte stage. The reticulocyte is slightly larger, 7–10 mc, than a mature erythrocyte. These cells can be identified in vitro by reaction with supravital stains, new methylene blue, or brilliant cresyl blue, which cause precipitation of the RNA and mitochondria. Normally, reticulocytes compose 0.5–2.0% (absolute concentration 25-75 * 109/L) of peripheral blood erythrocytes in a nonanemic adult. Jabir ibn hayyan medical university/ faculty of medicine  Blood Physiology Lab.1 By: Hussein R. Alasady ____________________________________________________________________________ A very useful measurement in determining the cause of normocytic anemia is the reticulocyte count. Reticulocytes are newly formed red blood cells that have recently lost their nuclei but retain high levels of cytosolic mRNA dedicated to the synthesis of hemoglobin. This RNA reacts with the dye, methylene blue, to give a bright- green color, making it possible to perform reticulocyte counts. Effective erythropoiesis is assessed by the reticulocyte count. Hyperproliferative normocytic anemias, associated with an increased reticulocyte count, include both hemolytic anemia and the anemia associated with acute blood loss, Reagent: One percent new methylene blue in a diluent of citrate/ saline (1 part 30 g/L sodium citrate plus 4 parts 9 g/L sodium chloride). Jabir ibn hayyan medical university/ faculty of medicine  Blood Physiology Lab.1 By: Hussein R. Alasady ____________________________________________________________________________ Procedure:- Three drops each of reagent and blood are mixed in a test tube, incubated 15 minutes at room temperature, and remixed. Two wedge films are made on glass slides and air dried. Viewed microscopically with an oil immersion lens, reticulocytes are pale blue and contain dark blue reticular or granular material, and red cells stain pale blue or blue- green. Count at least 10 fields. Absolute reticulocyte (* 109/L) = RBC count (* 1012/L) * Retic count (%) Jabir ibn hayyan medical university/ faculty of medicine  Blood Physiology Lab.1 By: Hussein R. Alasady ____________________________________________________________________________  Why do we need a reticulocyte count? 1. Other blood tests show your red blood cell levels are not normal. These tests may include a complete blood count, hemoglobin test, and/or hematocrit test. 2. Monitor the treatment with radiation or chemotherapy. 3. Monitor the bone marrow transplant. 4. Monitor the symptoms of anemia. They include:  Shortness of breath  Weakness or fatigue  Headache  Dizziness  Arrhythmia (a problem with the rate or rhythm of your heartbeat)  Sometimes newborn babies may have a reticulocyte count test to check for a blood disorder called hemolytic disease of the newborn (HDN).  Clinical Significant:-  Reticulocytosis (increase in circulating reticulocytes):- 1. Hemolytic anemia, 2. New or ongoing bleeding (hemorrhage), 3. Hemolytic disease of the newborn (HDN).  Decrease in Reticulocyte count:- 1. Iron deficiency anemia. 2. Pernicious anemia. 3. Aplastic anemia. 4. Bone marrow failure. 5. Kidney disease. 6. Cirrhosis, or scarring of the liver. Jabir ibn hayyan medical university/ faculty of medicine  Blood Physiology Lab.1 By: Hussein R. Alasady ____________________________________________________________________________  If reticulocyte test results were not normal, it doesn't always mean you have anemia or another health condition such as in : 1. Reticulocyte counts may be higher during pregnancy. 2. Increase in high altitude. The count should return to normal once your body gets used to the lower oxygen levels that happen in higher altitudes. 3. Some medicines may increase or decrease your reticulocyte count.  Ref: 1. Henry's Clinical Diagnosis and Management by Laboratory Methods-Elsevier Inc. 2. Clinical Laboratory Hematology Mckenzie/Williams. 3. Hoffbrand’s Essential Haematology ALL THE BEST Jabir ibn hayyan medical university/ faculty of medicine