ACTIVITY 14

RETICULOCYTE COUNT

1. Describe reticulocyte in vivo.

reticulocytes are immature red blood cells (RBCs) containing RNA remnants. Maturation to
discocytes depends on energy and occurs during progressive stages in which RNA content
decreases, protein synthesis becomes complete and the plasma membrane and cytoskeleton
become remodeled. The entire in vivo process takes place in about three days in bone marrow
followed by one to two days in the peripheral blood and is dependent on erythropoietic

Reference:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2531-13792018000200143

2. Give the normal values ( infants & adults) and the clinical significance of decreased and
increased reticulocyte count.
The normal fraction of reticulocytes in the blood depends on the clinical situation but is usually
0.5% to 2.5% in adults and 2% to 6% in infants.

✓High reticulocyte levels could be a sign of:

● acute bleeding
● chronic blood loss
● hemolytic anemia
● erythroblastosis fetalis, also called hemolytic disease in a newborn, a potentially fatal
blood disorder that affects some fetuses and newborns
● kidney disease

✓Low reticulocyte levels could indicate:

● iron deficiency anemia

● aplastic anemia
● folic acid deficiency
● vitamin B-12 deficiency
● bone marrow failure caused by drug toxicity, infection, or cancer
● kidney disease
● cirrhosis
● side effects from radiation therapy

Reference:https://www.healthline.com ›

3. Describe the Miller disc. Give the formula.

The Miller Disc or Miller Square reticle is used for common counting applications. This reticle
enables the operator to determine the number of particles in one of the smaller squares on the
reticle, then multiply the result to calculate the total number of particles contained within the
reticle boundaries. Miller reticles are also useful when comparing the proportion of large to small
particles in a specimen.

FORMULA:

Retic% = total # of retic large squareX 100

total # of retic in small square x 9

Reference: https://www.researchgate.net › 2976...(PDF) The Miller Disk: An Improvement in the

Performance of Manual Reticulocyte Counts

4. What is polychromasia? Give the formula

Polychromasia is a disorder where there is an abnormally high number of immature red blood
cells found in the bloodstream as a result of being prematurely released from the bone marrow
during blood formation. (poly- refers to many, and -chromasia means color.)

FORMULA:
CRC = Retic% x Hct(L/L)
0.45L/L

Reference:https://www.healthline.com healthWeb resultsPolychromasia: What It Is, Causes,

Symptoms, Treatment - Healthline

5. What are the other associated measurements/correction for reticulocytes? Give their
formulas.

Absolute reticulocyte count: actual number of reticulocytes in 1 Liter of whole blood.

FORMULA:
ARC = Retic%xRBCcount(X10^12/L)X1000
100

Corrected Reric count: retic count to a normal Hct to allow correction for tue degree of patient
anemia

FORMULA:
CRC = Retic% X Hct(L/L)
0.45L/L
Reference:https://www.sciencedirect.com › topicsWeb resultsReticulocyte Count - an overview |
ScienceDirect Topics

6. Differentiate between intravascular and extravascular hemolysis.

Intravascular hemolysis describes hemolysis that happens mainly inside the vasculature. As a
result, the contents of the red blood cell are released into the general circulation, leading to
hemoglobinemia and increasing the risk of ensuing hyperbilirubinemia. Extravascular hemolysis
RBCs are phagocytized by macrophages in the spleen and liver. Causes include RBC
membrane abnormalities such as bound immunoglobulin, or physical abnormalities restricting
RBC deformability that prevent egress from the spleen. Extravascular hemolysis is
characterized by spherocytes.

Reference: Hemolytic Anemia - The Student Source - University of Virginia

Mechanisms | eClinpath