Clinico-hematological correlation of pancytopenia with special reference to the role of IRF (immature reticulocyte fraction) by automated cell counter in a tertiary care hospital

Authors

  • Suchandra Ray Associate Professor, Department of Pathology IPGME&R, Kolkata, West Bengal, India
  • Sudip Roy PGT 3rd Year, Department of Pathology, IPGME&R, West Bengal, India
  • Chhanda Das Assistant Professor, Department of Pathology, IPGME&R, West Bengal, India
  • Moumita Sengupta Associate Professor, Department of Pathology, IPGME&R, Kolkata, West Bengal, India
  • Sreejita Mridha PGT 3rd Year, Department of Pathology, IPGME&R, Kolkata, West Bengal, India

Keywords:

Pancytopenia, Anaemia, Reticulocyte Count, Immature Reticulocyte Fraction (IRF).

Abstract

Background : Pancytopenia is an important entity worldwide but with varying patterns in clinical presentations. Bone marrow aspiration and biopsy are considered as primary investigation to evaluate and diagnose the causes of pancytopenia. But before doing a bone marrow aspiration or biopsy, a note on the newer reticulocyte indices given by automated cell counters other than reticulocyte percent and absolute reticulocyte count helps us to get a picture about the marrow erythropoietic activity which also bypasses the inter-observer variability. These newer reticulocyte indices are the Immature Reticulocyte Fraction (IRF), Reticulocyte Hemoglobin Content (CHr or Ret-He), difference between the reticulocyte and erythrocyte hemoglobin content (Delta-He).We attempted to emphasize the importance of Immature Reticulocyte Fraction (IRF) over other reticulocyte indices in diagnosis of pancytopenia and assessment of marrow response to therapy.Methods: In this study patient’s history were taken. Then EDTA mixed blood examined by Automated Cell Counters (Sysmex XT-4000i) and subsequently bone marrow examination has been done to confirm the etiology. Results were calculated statistically.Results: We found that values of IRF were also significant in the diagnoses of Megaloblastic Anaemia, Aplastic Anaemia, early Marrow Recovery from suppression, Hemolytic Disease and Chronic Diseases.Conclusion: It is hypothesized that IRF is an index of acceleration and the absolute reticulocyte count is a quantitative measurement of the effectiveness of erythropoiesis. So after initiation of treatment, repeated observation of both IRF and Reticulocyte Count may be helpful to observe the effectiveness of therapy.

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Published

2021-03-10

How to Cite

Ray, S., Roy, S., Das, C., Sengupta, M., & Mridha, S. (2021). Clinico-hematological correlation of pancytopenia with special reference to the role of IRF (immature reticulocyte fraction) by automated cell counter in a tertiary care hospital. International Journal of Health and Clinical Research, 4(5), 62–66. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/1073