Reticulocyte

An immature red blood cell without a nucleus, having a granular or reticulated appearance when suitably stained.
Reticulocytes are the immature RBC that contain nucleus.
They are originally seen at the site of their formation i.e. bone marrow. They take 2-3 (lays for maturation only about 1-2% of circulating RBCs are Reticulocytes.

1. Reticulocyte Ms Ankita R Bhatiya Assistant Professor Shree P.M.Patel COLLEGE OF PARAMEDICAL SCIENCE N TECHNOLOGY

2. It include: 1.What is RE? 2. Method for detection of RE.

3. Reticulocyte Introduction : Definition: An immature red blood cell without a nucleus, having a granular or reticulated appearance when suitably stained. Reticulocytes are the immature RBC that contain nucleus. They are originally seen at the site of their formation i.e. bone marrow. They take 2-3 (lays for maturation only about 1-2% of circulating RBCs are Reticulocytes .

4. Reticulocyte Aim : To determination of Reticulocytes count. Clinical Significance : The number of Reticulocytes in peripheral blood is a reflection of red cell forming activity of bone marrow. Increase in Reticulocytes count indicates increased activity of the bone marrow. This is known as Reticulocytosis . It is seen in Haemolytic anaemia or acute blood loss. Low count of Reticulocytes indicates suppression of bone marrow. It is seen in aplastic anaemia. Method : Supra vital method

5. Reticulocyte Normal Range: Adults: - 0.2 to 2 % Infants: - 2 to 6 % Principle: Supravital staining method is used for Reticulocytes count. Blood is mixed with the stain & the stain enters the cells in living condition. The RNA in the cells is precipitated by staining, as dark blue network. Blood smear is made afterwards. Since direct count is not possible, a relative count is taken against the number of Red blood cells & expressed as a % of Red cells.

6. Reticulocyte Requirements: 1. Glass slides 2. Test tube 3. Pasteur pipette 4. Microscope 5. Staining solution :(Staining solution contain Brilliant cresyl blue (1.0g), Na citrate (0.4g), NaCl (0.85g) & distilled water (100ml) Dissolve first Na citrate in Na chloride & then the dye. Filter it & store in a plastic container. Specimen: - EDTA blood sample or capillary heparinized blood. Perform the test within 2 to 3 hr of blood collection.

7. Reticulocyte Procedure: 1.Identify the right patient. 2. Collect all the requirements. 3. Do the labelling. 4.Collect required amount of blood by vein or capillary puncture. 5. Filter a small amount of the stain. 6. In a labelled test tube take two drops a blood & two drops stain by using two separate Pasteur pipette. 7. Mix properly then cover the tubes with cotton plug & keep it at 37 degrees for 30 minutes. 8. Prepare a thin smear of the stained blood specimen. 9. Air-dry the smear. 10. First examine the smear under the low power than change it to the oil immersion objective. 11. Reticulocytes are identified by line, deep violet filaments & granules arranged in a network. Red cells stain pale blue. Simultaneously count Reticulocytes & red cells in about 15 fields.

8. Reticulocyte Calculation: Example: Total no. of red cell counted = 1500 No. of reticulocytes seen = 75 Reticulocytes % = 75 x 100 -------------- 1500 = 5%

9. Reticulocyte Additional Information: 1. Staining time should not be less than 30 min. 2. Mix the blood & the stain gently but thoroughly prior to making the smear. This is imp. The Reticulocytes have a lower specific gravity than maturated cells & therefore settle on top of the red cells in the mixture. Thus an unmixed or poorly mixed blood specimen may not give the true picture. 3.Red cells showing highly refractive areas may be confused with Reticulocytes . These artefacts in the red cells are probably due to moisture in the air & poor drying of the smear. Use fresh specimen.