Utility of Automated Reticulocyte Research Parameters derived from Beckman Coulter DXH800 in Nutritional Deficiency Anaemias

Introduction: Reticulocyte parameters obtained from the automated analyzers have gained importance not only in the classification of anemias but also in therapeutic monitoring. Their role in nutritional anemia is by far limited to monitoring the hematinic response. The present study aims to describe the distribution of various reticulocyte parameters obtained from Beckman Coulter DXH 800 in cases of nutritional deficiency anemias. Method: Reticulocyte parameters of iron deficiency anemia (IDA) (n=146), megaloblastic anemia (MA) (n=119), and mixed deficiency anemia (n=32) were compared with a non-anemic healthy control group (n=68). Independent sample T-test and one-way ANOVA were used for comparisons. Results: The RET%, MRV, IRF, MSCV, HLR%, RSF, RDWr, and RDWr-SD were significantly higher in MA than in other groups and a significant inverse correlation of Hb was seen with MRV, RDWr, and RDWr-SD. In IDA there was a significant increase in RET%, ARC, IRF, HLR%, HLR#, and RDWr, and a reduction in MRV, MSCV, and RSF. The strongest positive correlation of Hb was with RSF. In the mixed deficiency anemia group, there was an increase in RET%, ARC, IRF, HLR%, HLR#, and RDWr and a reduction in MRV, MSCV, and RSF. Cases on treatment had significantly higher RET%, ARC, and HLR# compared to those without irrespective of etiology. Conclusion: The study strengthens the utility of RSF as a marker of iron-restricted erythropoiesis, and a low RSF and higher MRV in differentiating IDA from mixed deficiency anemia. Irrespective of the etiology, RET%, ARC, HLR%, and HLR# can be utilized for monitoring therapy in nutritional anemias.