Do we have high reticulocyte count in Thalassemia Major? - USMLE Forums
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Old 01-22-2011
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RBC Do we have high reticulocyte count in Thalassemia Major?

1-do we have high retic count in Beta thalassemia major?
since we have hemolysis i expect high RET count BUT i read this case from FA Q&A ,,a 7 months boy with beta thalassemia and jaundice but 0.3% retic count!!

2-and i want to know why there is high risk of P.HTN in B thalassemias??
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Old 01-22-2011
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Originally Posted by hana View Post
do we have high ret in B talasemia major?
since we have hemolysis i expect high RET count BUT i read this case from FA ,,a 7 months boy with b thlassemia and jundice but 0.3% ret!!
I think you would normally see a high reticulocyte count. Maybe it was an uncorrected reticulocyte count? Did the question include a hematocrit? To calculate a corrected reticulocyte count, you divide the actual hematocrit by 45 (normal hct), then multiply that times the reticulocyte count. That said, 0.3% seems WNL even with a correction factor...

Are you sure the question said β-Thal major and not β-Thal minor?
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Old 01-22-2011
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Arrow There should be high retics

You have to have high retic count in any hemolytic anemia.
I agree with mondoshawan that the case could have been thalassemia minor (but the jaundice is there, which means there must be hemolysis).
The other possibility is that the patient might be having some viral infection with aplastic crisis but again he wouldn't show jaundice.

I suggest you post for us the complete case that you got and let's discuss it appropriately.
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Old 01-23-2011
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Originally Posted by Hokolesqua View Post
You have to have high retic count in any hemolytic anemia.
I agree with mondoshawan that the case could have been thalassemia minor (but the jaundice is there, which means there must be hemolysis).
The other possibility is that the patient might be having some viral infection with aplastic crisis but again he wouldn't show jaundice.

I suggest you post for us the complete case that you got and let's discuss it appropriately.
Yeah I would like to post the whole question but I am afraid we are banned from posting original questions here, so here is just summery;
7 month old Greek recently -about 2 w- with jaundice, was ok before that.
lab test; MCV 75 AND RET count of 0.3% ,NL serum iron (this was the whole scenario given)

then in explanation it says;
ret count is low b/c of ineffective hematopoesis.

I use FA 2007 U CAN CHECK IT OUT AT P174
the only logic comming to my mind; maybe still it is too soon to see the rets in blood? i do not know how long it takes to see increased rets? is 2 week enough?
however still i do not get why FA says "ineffective" hematopoesis
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Old 01-23-2011
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It should take less than a week to see elevated reticulocyte count in the blood.

I'm still not sure why you think it's a Beta Thalassemia, unless the explanation says it is. It could be HbH disease (3/4 alpha genes), but couldn't it also be G6PD deficiency, or even SCA with an early crisis brought on by parvovirus B19? I don't have Q&A 2007, so I don't really know what the question was asking or what the answer choices were, but it just doesn't sound right for Beta Thalassemia...
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Old 01-23-2011
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Arrow Which book you mean?

Quote:
Originally Posted by hana View Post
I use FA 2007 U CAN CHECK IT OUT AT P174
Which FA 2007 you are referring to? I have FA 2007 in my library and I couldn't see such thing in it in page 174. Do you mean FA Q&A or FA Cases?
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Old 01-23-2011
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Originally Posted by hokolesqua View Post
which fa 2007 you are referring to? I have fa 2007 in my library and i couldn't see such thing in it in page 174. Do you mean fa q&a or fa cases?
oh, it is actualy 2006 ,the first aid cases,,,section hematology case#4

@mondoshawn;i did not say i think it is b thalasemia,the book says that.
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