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Calculated as [%reticulocyte count x Patient Hct] / 45(normal Hct). This adjustment provides insight into whether reticulocyte production is adequate for the level of anemia. [1] Complete Blood Count (CBC): Provides a value for a variety of blood components, including red blood cells, hemoglobin, and hematocrit levels. [10]
The diagnosis of hemolytic anemia can be suspected on the basis of a constellation of symptoms and is largely based on the presence of anemia, an increased proportion of immature red cells (reticulocytes) and a decrease in the level of haptoglobin, a protein that binds free hemoglobin.
The problem arises because the reticulocyte count is not really a count but rather a percentage: it reports the number of reticulocytes as a percentage of the number of red blood cells. In anemia, the patient's red blood cells are depleted, creating an erroneously elevated reticulocyte count. [1]
A reticulocyte percentage that is higher than "normal" can be a sign of anemia, but this depends on the health of a person's bone marrow. Calculating the reticulocyte production index is an important step in understanding whether or not the reticulocyte count is appropriate to the situation. This is often a more important question than whether ...
For the patient with isolated reticulocytopenia and anemia without significant disturbances in other cell lineages, the initial evaluation may include some of the following studies: [7] Complete blood count with differential; Peripheral blood smear; Type and Cross (in case transfusion is needed) Reticulocyte Production Index
If the reticulocyte count is increased, but the haptoglobin level is normal, this argues against haemolysis, and suggests a bone marrow response to blood loss. If there are symptoms of anemia but both the reticulocyte count and the haptoglobin level are normal, the anemia is most likely not due to hemolysis.
The reticulocyte production index is a calculation of the ratio between the level of anemia and the extent to which the reticulocyte count has risen in response. If the degree of anemia is significant, even a "normal" reticulocyte count actually may reflect an inadequate response.
Anemia with a high reticulocyte count can indicate that the bone marrow is producing red blood cells at a higher rate to compensate for blood loss or hemolysis, [74] while anemia with a low reticulocyte count may suggest that the person has a condition that reduces the body's ability to produce red blood cells. [168]