Count, Maturity Level and Haemoglobin Content of Reticulocytes in an Ivorian Population in Apparent Good Health: A Prospective Cross-Sectional Study in Bouaké
Dénombrement, Degré de Maturité et Teneur en Hémoglobine des Réticulocytes dans une Population Ivoirienne en Bonne Santé Apparente : Une Étude Transversale Prospective à Bouaké
DOI:
https://doi.org/10.5281/zenodo.17762237Keywords:
Hemogram, Reticulocyte, Fluorescence flow cytometry, Iron deficiency anemiaAbstract
RÉSUMÉ
Introduction. La carence en fer est une cause majeure d'anémie en Afrique subsaharienne, mais son diagnostic précoce, avant l'apparition de l'anémie, reste difficile avec les paramètres hématologiques conventionnels. Le contenu en hémoglobine des réticulocytes (RET-He), mesuré par les automates modernes, émerge comme un biomarqueur sensible de la carence martiale fonctionnelle. Cette étude visait à établir le profil des paramètres réticulocytaires avancés, incluant le RET-He, et à évaluer l'influence des facteurs démographiques dans une population adulte de Côte d'Ivoire. Méthodologie. Nous avons mené une étude transversale prospective d'un mois au laboratoire central du Centre Hospitalier Universitaire (CHU) de Bouaké. Cent vingt sujets adultes apparemment sains ont été inclus. L'analyse des paramètres réticulocytaires a été réalisée sur un automate Sysmex XN-550. Résultats. L'âge moyen des participants était de 29 ans, avec une prédominance masculine (sex-ratio H/F=2,24). Les ethnies allogènes composées d’Akan et de Krou dominaient avec un pourcentage de 53,3%. Les valeurs moyennes de l’hémogramme de routine étaient normales GB : 6100/ul, taux Hb : 13,4 g/dl et PQ : 232 000/ul. Nous avons retrouvé une moyenne du nombre de réticulocytes de 59378 ± 20634/ul avec des extrêmes de 25000 à 101100/ul, une fraction immature des réticulocytes légèrement élevée (13,4 ± 6,14) avec sa fraction High Fluorescence Réticulocytaire (HFR) très élevée. Il y avait une évolution inversement proportionnelle entre les fractions LFR et HFR. Le taux moyen de RET-He était de 26,59 ± 2,26 pg, une valeur inférieure aux seuils de référence internationaux pour des adultes en bonne santé. L'analyse a montré que l'âge et l'appartenance ethnique influençaient de manière statistiquement significative les paramètres hématologiques notamment le RET-He et l'IRF Conclusion. Un taux de RET-He abaissé dans cette cohorte ivoirienne, malgré des paramètres hématologiques standards normaux, suggère une forte prévalence de carence en fer sous-jacente. L'intégration du RET-He dans le bilan sanguin de routine offre un outil précieux pour le dépistage précoce. L'influence des facteurs ethniques souligne la nécessité d'établir des valeurs de référence locales.
ABSTRACT
Introduction. Iron deficiency is a major cause of anaemia in sub-Saharan Africa, but early diagnosis, before the onset of anaemia, remains difficult with conventional haematological parameters. Reticulocyte haemoglobin content (RET-He), measured by modern automated analysers, is emerging as a sensitive biomarker of functional iron deficiency. This study aimed to establish the profile of advanced reticulocyte parameters, including RET-He, and to assess the influence of demographic factors in an adult population in Côte d'Ivoire. Methodology. We conducted a one-month prospective cross-sectional study at the central laboratory of the Bouaké University Hospital Centre (CHU). One hundred and twenty apparently healthy adult subjects were included. Reticulocyte parameters were analysed using a Sysmex XN-550 automated analyser. Results. The average age of participants was 29 years, with a predominance of males (sex ratio M/F=2.24). Ethnic minorities comprising Akan and Krou dominated with a percentage of 53.3%. The average values of the routine blood count were normal: GB: 6,100/μl, Hb level: 13.4 g/dl and PQ: 232,000/μl. We found an average reticulocyte count of 59,378 ± 20,634/μl with extremes ranging from 25,000 to 101,100/μl, a slightly elevated immature reticulocyte fraction (13.4 ± 6.14) with a very high High Fluorescence Reticulocyte (HFR) fraction. There was an inversely proportional relationship between the LFR and HFR fractions. The mean RET-He level was 26.59 ± 2.26 pg, which is below the international reference thresholds for healthy adults. The analysis showed that age and ethnicity had a statistically significant influence on haematological parameters, particularly RET-He and IRF. Conclusion. A lowered RET-He level in this Ivorian cohort, despite normal standard haematological parameters, suggests a high prevalence of underlying iron deficiency. The inclusion of RET-He in routine blood tests provides a valuable tool for early screening. The influence of ethnic factors highlights the need to establish local reference values.
References
1. Longanbach S, Miers MK. Automated blood cell analysis. Rodak’s Hematol Clin Princ Appl Elsevier Saunders St Louis. 2016;208‑34.
2. Uçar MA, Falay M, Dağdas S, Ceran F, Urlu SM, Özet G. The Importance of RET-He in the Diagnosis of Iron Deficiency and Iron Deficiency Anemia and the Evaluation of Response to Oral Iron Therapy. J Med Biochem. oct 2019;38(4):496‑502.
3. Pérez-Écija A, García FJM. Diagnostic use of the reticulocyte maturity indices provided by the Sysmex XN-V analyser. 2021;5.
4. Koepke (1986): Reticulocytes. Clin Lab Haematol 8, 169 – 179.
5. Flowers: A serum ferritin assay for prevalence studies... - Google Scholar https://scholar.google.com/scholar_ pages=141-51
6. D’Onofrio G, Chirillo R, Zini G, Caenaro G, Tommasi M, Micciulli G. Simultaneous measurement of reticulocyte and red blood cell indices in healthy subjects and patients with microcytic and macrocytic anemia. 1995 ;85(3) :818-23.
7. Morkis IVC, Farias MG, Scotti L. Determination of reference ranges for immature platelet and reticulocyte fractions and reticulocyte hemoglobin equivalent. Rev Bras Hematol E Hemoter. déc 2016; 38:310‑3.
8. Sheng-Hang Z , Yan Wang , Fei-Fei Luo , Zhi-Yao Cao , Li-Juan Yang , Chang-Guo Gu. Reference Intervals for Reticulocyte Hemoglobin Content, Mean Reticulocyte Volume and Reticulocyte Count Percentage in Healthy Han Ethnic Adults of Chengdu. Clin Lab. 1 sept 2020 ;66(9).
9. Traore AM. Intérêt de l’index de production réticulocytaire en zone urbaine et rurale de la mali. 2008.
10. 10.Hoffmann JJML, Broek NMA van den, Curvers J. Reference intervals of extended erythrocyte and reticulocyte parameters. Clin Chem Lab Med. 1 mai 2012;50(5):941‑8.
11. Nunes LAS, Grotto HZW, Brenzikofer R, Macedo DV. Hematological and biochemical markers of iron status in a male, young, physically active population. BioMed Res Int. 2014;2014.
12. Fırat Oğuz E, Falay M, Ercan Karadağ M, Uzdoğan EA, Akbulut ED, Özet G, et al. Determination of reference ranges for automated erythrocyte and reticulocyte parameters in healthy adults. Turk J Biochem Biyokim Derg. 2021.
13. Banfi G, Mauri C, Morelli B, Di Gaetano N, Malgeri U, Melegati G. Reticulocyte count, mean reticulocyte volume, immature reticulocyte fraction, and mean sphered cell volume in elite athletes: reference values and comparison with the general population. Clin Chem Lab Med CCLM. 2006;44(5):616‑22.
14. D’Onofrio G, Chirillo R, Zini G, Caenaro G, Tommasi M, Micciulli G. Simultaneous measurement of reticulocyte and red blood cell indices in healthy subjects and patients with microcytic and macrocytic anemia. 1995 ;85(3) :818-23.
15. Canals C, Remacha AF, Sarda MP, Piazuelo JM, Royo MT, Romero MA. Clinical utility of the new Sysmex XE 2100 parameter-reticulocyte hemoglobin equivalent-in the diagnosis of anemia. Haematological. 2005;90(8):1133‑4.
16. Santamaria A, Martino R, Bellido M, Remacha AF. Reticulocyte recovery is faster in allogeneic and autologous peripheral blood stem cell transplantation than in bone marrow transplantation. Eur J Haematol. 1997;58(5):362‑4.
17. Batjer JD, Riddell K, Fritsma GA. Predicting bone marrow transplant engraftment by automated flow cytometric reticulocyte analysis. Lab Med. 1994;25(1):22‑6.
18. Bourée P. Immunity and immunization in elderly. Pathol Biol. 2003;51(10):581‑5.
19. Bossche JVD, Devreese K, Malfait R, Vyvere MVD, Wauters A, Neels H, et al. Reference intervals for a complete blood count determined on different automated haematology analysers: Abx Pentra 120 Retic, Coulter Gen-S, Sysmex SE 9500, Abbott Cell Dyn 4000 and Bayer Advia 120. 2002;40(1):69-73.
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Copyright (c) 2025 Mahi C E Gnemagnon, Botti Renee Paule, Ouattara Awa, N’dri Aya Annick Charlene, Koffi Konan Jacques Fabrice, Grahouri Joel Kouadio Betsaleel, Boignon Patrick, Ayemou Romeo
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