anemia question
Started by medicinehopeful
Basically, reticulocytes are young RBC's. When you have anemia, the bone marrow compensates by increasing production of RBC's, and the new RBC's leave the bone marrow and get into circulation before they are fully mature. When you have a condition where you get a bad marrow response such as aplastic anemia, you will have either none or a very low reticulocyte count, because the bone marrow is not creating any new RBC's, therefore no young RBC's are getting into circulation simply because the bone marrow isn producing any.
Yeah, reticulocytes are denucleated RBC precursors that have not yet lost their RNA meshwork, so they stain blue and can be differentiated from mature RBCs. They are also bigger, so the Mean Corpuscular Volume (MCV) can also be used as a measure of how many immature RBC's are being sent into circulation, and aplastic anemia is a good example of when the bone marrow does not respond to hematologic pancytopenia with a proper response of increasing the production of RBCs. Additionally, band neutrophils indicate the same priniciple with leukocytes, and would similarly confirm some sort of leukemia in an cute infection.
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It depends on the cause. If there is a known causative agent (drug, infection, toxin), then you need to deal with that. Transfusions are standard but will only work for so long --- which is why it's important to determine the cause. Growth factors can be given to try to stimulate hematopoeisis. BMT can be curative but rejection is problematic.
Wait. I could have sworn that reticulocytes were larger, in part, because they still retained a partial nucleus that than becomes denucleated...
The nucleus is shed as erythroblasts transform into reticulocytes. Reticulocytes are larger because of their semi-immature cytoplasm, which still contains RNA and some organelles. There can be tiny nuclear fragments left behind, but, in general, reticulocytes lack a nucleus.
