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Velasco-Rodríguez, DiegoCorresponding Author

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Reticulocyte parameters of delta beta thalassaemia trait, beta thalassaemia trait and iron deficiency anaemia

Publicated to:JOURNAL OF CLINICAL PATHOLOGY. 69 (2): 149-154 - 2016-02-01 69(2), DOI: 10.1136/jclinpath-2015-203034

Authors: Velasco-Rodriguez, Diego; Alonso-Dominguez, Juan-Manuel; Gonzalez-Fernandez, Fernando-Ataulfo; Villarrubia, Jesus; Sopena, Maria; Abalo, Lorena; Ropero, Paloma; Martinez-Nieto, Jorge; de la Fuente Gonzalo, Felix; Cava, Fernando

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Abstract

Aims To analyse the differences in reticulocyte indices between delta beta thalassaemia trait (delta beta-TT), beta thalassaemia trait (beta-TT) and iron deficiency anaemia (IDA), and to correlate those differences with the physiopathological features of these three types of microcytoses. Methods We performed a descriptive study of 428 samples (43 delta beta-TT, 179 beta-TT and 206 IDA) that were run on Advia 2120 analyser (Siemens). The following reticulocyte indices were assessed: absolute reticulocyte count (ARC), percentage of reticulocytes, mean corpuscular volume of reticulocytes (MCVr), haemoglobin content of reticulocytes (CHr), mean corpuscular haemoglobin concentration of reticulocytes, red blood cell distribution width of reticulocytes (RDWr), haemoglobin distribution width of reticulocytes (HDWr) and reticulocyte subpopulations based on their fluorescence according to mRNA (low (L-R), medium (M-R) and high (H-R)), MCV ratio and MCHC ratio. Correlation between fetal haemoglobin (HbF) and RDWr in patients with thalassaemia was evaluated. Results RDWr was significantly higher in delta beta-TT compared with beta-TT (15.03% vs 13.82%, p < 0.001), and so were HDWr (3.65% vs 3.27%, p < 0.001), CHr (23.68 vs 22.66 pg, p < 0.001) and MCVr (88.3 vs 85.5 fL, p < 0.001). A good correlation was observed between HbF and RDWr (r = 0.551, p < 0.001). IDA subjects have more immature reticulocytes, but less ARC than beta-TT, suggesting a certain degree of inefficient erythropoiesis in IDA in comparison with beta-TT. Conclusions Previously described differences between delta beta-TT, beta-TT and IDA in the corpuscular indices of mature red blood cell can also be observed in reticulocytes. The degree of anisocytosis in reticulocytes from patients with thalassaemia is correlated with HbF.

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