IP Journal of Diagnostic Pathology and Oncology 2023;8(1):30–35
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IP Journal of Diagnostic Pathology and Oncology
Journal homepage: https://www.jdpo.org/
Original Research Article
Novel reticulocyte parameters in thalassemia and iron deficiency anemia
Kirtijit Chakma
1,
*, Rashmi Kuswaha
1
, Geeta Yadav
1
, U.S Singh
1
, Wahid Ali
1
,
Ashutosh Kumar
1
, S.P Verma
2
, Nishant Verma
3
, Trideep Jyoti Deori
4
1
Dept. of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh, India
2
Dept. of Clinical Hematology, King George’s Medical University, Lucknow, Uttar Pradesh, India
3
Dept. of Paediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
4
Dept. of Community Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India
ARTICLE INFO
Article history:
Received 27-07-2022
Accepted 28-01-2023
Available online 29-03-2023
Keywords:
HFR
Ret-He
Immature reticulocyte fractions
Iron deficiency anemia
Thalassemia
Reticulocytes
ABSTRACT
Introduction: Reticulocytes are immature, non-nucleated RBCs that still contain RNA. It provides useful
information about the capacity of the bone marrow to synthesize and release red cells in response to anemia
and helps to distinguish between decreased RBC production and enhanced peripheral destruction.
Materials and Methods: A prospective study was done between thalassemia and iron deficiency anemia
cases. The duration of the study was 1 year where 139 cases were included. In our study, a total of 139
patients are included out of which 94 cases were of Thalassemia and 45 cases of Iron deficiency anemia.
Measurement of complete blood count (CBC) with reticulocyte fractions was done in the SYSMEX XN-
550 system and for serum ferritin, Architect iSystem was used.
Results: This study demonstrates the cut-off value of IRF for detecting Thalassemia trait as 15.85-21.50%,
IDA was >21.50% and for Thalassemia major it was < 15.85%. The LFR% optimum cut-off for detecting
Thalassemia trait was estimated to be 83.1-84.2%, IDA <83.1%and for Thalassemia major it was >
84.2%. The MFR% optimum cut-off for detecting Thalassemia trait was estimated to be <12.9%, IDA
was >13.25% and for Thalassemia major it was 12.9-13.25%. The HFR% optimum cut-off for detecting
Thalassemia trait was estimated to be 2.4-5.3%, IDA was >5.3%and for Thalassemia major it was < 2.4%.
Conclusion: The use of new hematological parameters and doing further comparative-based studies will
help in differentiating various types of anemia and give knowledge of physiopathology of the underlying
disease.
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1. Introduction
Reticulocytes are immature, non-nucleated red blood cells
(RBCs) that still contain ribonucleic acid (RNA). It provides
useful information about the capacity of the bone marrow to
synthesize and release red cells in response to anemia and
helps to distinguish between decreased RBC production and
enhanced peripheral destruction.
* Corresponding author.
E-mail address: kirtymster@gmail.com (K. Chakma).
Iron deficiency anemia (IDA) and thalassemia trait
(TT) are the most common cause of microcytosis and
their clinical management is quite different; so, the
discrimination between thalassemic and non-thalassemic
microcytosis has important implications.
1,2
Microcytosis accompanied by a high RBC count, normal
red cell distribution width (RDW) and an elevated level of
HbA2 are suggestive of Beta Thalassemia Trait (BTT).
3–5
Microcytosis accompanied by a low ferritin value suggests
iron deficiency.
6,7
https://doi.org/10.18231/j.jdpo.2023.006
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