Reticulocyte Count

RETICULOCYTE COUNT
 A reticulocyte count (retic count) is a blood test which measures the number of reticulocytes in the
blood.
 Reticulocytes are slightly immature red blood cells; basically, they are RBCs that are still
developing.
 Reticulocytes are immature red blood cells (RBCs) produced in the bone marrow and released
into the peripheral blood where they mature into RBCs within 1 to 2 days.
 Implication:
 A reticulocyte count that is above normal may indicate anemia. This is further supported by the
CBC results of the patients.
 Indi sure:
o An elevated reticulocyte count implies a bone marrow response to either increased RBC
destruction (hemolysis) or acute or chronic blood loss.
 An increase or decrease in reticulocyte count can be an indicator of erythropoiesis activity or
failure, especially relative to anemias
 Thus, usually, it can indicate hemolytic anemia.
o Although a 2014 study has stated that the indices related to immaturity of reticulocytes
are higher in the presence of iron deficiency.:
 An increase of immature reticulocytes in the blood of individuals with iron
deficiency anemia represents a response to anemia, as long as the medullary
tissue and the indispensable factors for erythropoiesis are preserved.
FERRITIN COUNT
 The purpose of a ferritin test is to determine whether your body is storing a normal amount of iron.
 Ferritin testing is used to screen for, diagnose, or monitor certain conditions.
 Ferritin testing is used as a screening tool along with other blood tests to look for low levels of iron or
iron deficiency, before symptoms develop.
 Ferritin is a blood protein that functions in the storage of iron.
 Unit = nanograms
 Implication
 Blood ferritin level that is below normal can indicate anemia (due to low iron stores and iron
deficiency) which eventually leads to a decrease in oxygen-carrying RBCs and thus, causes
pallor, pale lips, pale conjunctiva, and pale nail beds.
o Therefore, this can be one of the tests that confirm that low iron levels could explain the
different manifestations exhibited by the patient.
 Low levels of ferritin lead to iron-deficiency anemia. This means you have too few red blood cells. Iron
deficiency can come from a poor diet or blood loss, or your body may have trouble absorbing iron from
food.
 For the case of our patient, the most probable cause would be the malabsorption due to the
patient’s Hirschsprung Disease.
 Anemia in HD patients may primarily be caused by impaired iron absorption due to HD.
SERUM IRON TEST
 It is a type of blood test which measures the amount of iron in the blood.
 A serum iron test measures how much iron is in your serum.
 Serum is the liquid that’s left over from your blood when red blood cells and clotting factors have
been removed.
 Unit = micromoles
 Implication
 Low serum iron levels may indicate that the patient’s body does not have enough iron levels
and/or there is malabsorption of iron which can lead to anemia and eventually cause low blood
pressure, pallor, pale lips, and pale conjunctiva as there is not enough oxygen in the circulation
of the body
COMPLETE BLOOD COUNT

 The complete blood count (CBC) is the most common blood test.
 The complete blood count, also known as the CBC, is an essential comprehensive blood panel that
allows your doctor to evaluate each type of cell in your blood
 The purpose of a complete blood count is to give your health care provider, particularly your physician,
details about the state of your health.
 It is an important medical tool because it uses one sample to analyze the complete spectrum of cells
found in the blood as well as some of the characteristics of those cells.
 The primary uses for the CBC are diagnosis, monitoring, and screening
HEMOGLOBING (HGB)
 Hemoglobin measures the amount of this oxygen-carrying protein that is found inside RBCs.
 Hemoglobin is an iron-containing protein that facilitates oxygen delivery to cells in the body.
 Implication:
 Low hemoglobin levels may indicate and/or could lead to iron deficiency anemia.
 As per definition, Anemia refers to low levels of healthy red blood cells or hemoglobin.
 A low hemoglobin level is an indicator of a health condition called anemia
HEMATOCRIT
 Hematocrit measures the proportion of your total blood volume that consists of red blood cells.
 To put it simply, it is a test which measures the ratio of the volume of red blood cells to the total volume
of blood..
 Implication:
 Hematocrit levels that are below the normal range could indicate iron deficiency anemia due to
a lack of healthy RBCs.
 A low hematocrit level means the are too few red blood cells in the body.
 When there is a low hemoglobin level, there is often a low red blood cell count and a low hematocrit,
too.
 our hemoglobin and hematocrit are usually correlated—they typically are both normal or they both
increase or both decrease.
PLATELET
 Platelets are responsible for clotting the blood. Abnormal platelet function can mean that you bleed too
easily because your blood doesn’t clot properly, or it can mean that your blood is prone to excess
clotting.
 Thrombocytosis can be a result of a reactive process such as acute blood loss, infections, iron
deficiency anemia (IDA) or a clonal disorder such as Essential Thrombocythemia.’
 Iron deficiency induces thrombocytosis and enhances platelet aggregation.
 Pg = petagram
Mean Corpuscular Hemoglobin (MCH)

 An MCH value refers to the average quantity of hemoglobin present in a single red blood cell.
Mean Corpuscular Hemoglobin Concentration (MCHC)

 A calculated measurement of how concentrated hemoglobin is within red blood cells.
 MCHC checks the average amount of hemoglobin in a group of red blood cells.
Mean Corpuscular Volume (MCV)

 Mean corpuscular volume (MCV) is a measurement of the average size of red blood cells.
 Bigger size = macrocytosis
Mean Platelet Volume (MPV)

 The test may also measure the mean platelet volume (MPV), which is the size of your platelets.
FINDINGS INTERPRETATION EXPECTED FINDINGS AND/OR EXPLANATION
The sigmoid colon appear Sigmoid colon is normal in length and does not appear
Abnormal
redundant to be redundant
Implications:
 A redundant sigmoid colon indicates an abnormally elongated redundant colon and could lead to a
condition called sigmoid volvulus, which is a rare complication of Hirschsprung's disease.
Other info:
 A redundant sigmoid colon is defined as one that is too long to fit into its owner's body without
undergoing reduplication.
 Large intestine is abnormally long, particularly towards the descending colon area
 It is associated with acute and chronic pathological conditions, sigmoid volvulus
Substantial amount of fecal

materials seen in the distal
descending colon, sigmoid Abnormal No excessive fecal materials are retained in the colon..
colon, and rectum, due to
fecal retention.
Implications:
 Fecal retention may occur due to bowel obstruction and constipation caused by Hirschsprung Disease.
Other info:
 Faecal retention is best thought of as an incomplete elimination of stool and a tendency to retain
excessive stool in the colon or large intestine. It may be a problem even if the stools are not hard to
pass, painful or passed daily. Typically with faecal retention one or more large stools are passed
periodically to catch up the accumulation or retained stool (i.e. a large stool that plugs the toilet);
however, the retention cycle tends to repeat itself without proper treatment.
 One sign of Hirschsprung disease is constipation. An infant or child may strain to poop, pass hard
stools or poop infrequently.
There is mild gaseous

dilatation of the ascending
No dilatation and obstruction present and are within
and transverse colon. Abnormal
their normal limits or size.
Beginning distal large bowel
obstruction is not rule out.
Implications:
 Gaseous dilatation results from bacterial growth in the stagnant contents of an obstructed bowel. Gas
and stool build up and block the colon. Bowel obstruction can be due to Hirschsprung Disease.
Others:
Intra-abdominal calcification is common and the causes may be classified into four broad groups based on
morphology:

Reticulocyte Count

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RETICULOCYTE COUNT

COMPLETE BLOOD COUNT

Mean Corpuscular Hemoglobin (MCH)

Mean Corpuscular Hemoglobin Concentration (MCHC)

Mean Corpuscular Volume (MCV)

Mean Platelet Volume (MPV)

FINDINGS INTERPRETATION EXPECTED FINDINGS AND/OR EXPLANATION

Substantial amount of fecal

FINDINGS INTERPRETATION EXPECTED FINDINGS AND/OR EXPLANATION

There is mild gaseous

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