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This is what I have been told. A normal retic count is
between .5 and 1.5 in a normal healthy marrow. If you have a
hemoglobin of 8.2 and the retic is .7, it is calculated as a
percentage and the percentage of reticulocytes compared
to the hemoglobin is not enough. The retic count should be
like a 3 or 4 at the point of having such a low hemoglobin.
Also, I don't think DBAers
retic turn into mature cells. If I am wrong, correct me!
Sincerely,
Wendy-mom to Kimberly
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Here is what you need to know if you are looking at the
figure. Reticulocytes are "baby' red cells. They are just like
mature red cells except they still have some balled up
strands of RNA that can be seen under the scope. Now we
need to consider two different types of anemias to
understand what retic counts
mean.
If you are making a normal amount of red cells, a certain
percentage in the blood stream will be retics and can be
counted compared to the red cell count. So I think the
"retic" count is percentage of all red cells that are
reticulocytes. If you have a hemolytic anemia, where
something in the body is destroying red cells once they
leave the marrow, then when the kidneys ramp up EPO
production the marrow ramps up red cell production and
turns out lots of new cells.
In this case because an external problem is eating up
mature cells, the retic percentage will actually be higher
than normal. However, with DBA, in which case the
marrow is under producing(therefore hypoplastic anemia)
the retic count should be low.
If you are transfuse dependant, then you are getting
someone else's red cells and your marrow is not turning out
new cells, hence the lack of reticulocytes. What the
prednisone patients look for at the outset of prednisone
treatment is an increase in the retic count from low to
normal, because it is a sign that their own marrow has
begun producing red cells.
I hope this clarifies the issue. Retics confuse many of our
families
and there is no simple way to explain it.
Peace,
Bob Gunderson