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Integrating Reticulocyte Parameters into Anaemia Evaluation: A Functional Extension of Morphological Classification
Anjali Kelkar1 , Shamli Joshi2 , Vaishali Patil2 , Harshal Patil2
1- Ruby Hall Clinic , kelkar.anjali.jaydeep@gmail.com
2- Ruby Hall Clinic
Abstract:   (472 Views)
Background
Anaemia is a common clinical condition with diverse etiologies, traditionally classified using red cell indices such as mean corpuscular volume (MCV) and red cell distribution width (RDW). However, these parameters provide only static morphological information. Newer reticulocyte-derived indices—Mean Reticulocyte Volume (MRV), Immature Reticulocyte Fraction (IRF), and Red Cell Size Factor (RSF)—offer dynamic insights into erythropoietic activity and iron availability. This study aimed to evaluate the diagnostic and interpretive utility of these parameters across different anaemia types.
Methods
A prospective cross-sectional study was conducted in a tertiary care hospital over 24 months. A total of 357 adult patients with anaemia were classified morphologically as microcytic (n=162), normocytic (n=124), or macrocytic (n=71) based on MCV. Complete blood counts and reticulocyte indices were measured using the Beckman Coulter DxH 900 analyzer. Appropriate statistical methods were applied for data analysis. 
Results
Microcytic anaemia showed the lowest MRV (109.0 ± 17.6 fL) and RSF (92.6 ± 13.0), while macrocytic anaemia showed the highest MRV (125.9 ± 25.2 fL) and RSF (103.4 ± 28.8). IRF was comparable across groups (0.43–0.46) but reflected marrow activity in regenerative versus suppressed states. RSF emerged as the most discriminative index for differentiating iron deficiency anaemia from thalassemia trait (AUC = 0.89, p < 0.001). MRV refined morphological classification, and IRF indicated marrow responsiveness.
Conclusion
Reticulocyte parameters add functional depth to conventional red cell indices, bridging morphology with erythropoietic dynamics. Incorporation of these indices into routine haematology reporting can improve diagnostic accuracy and therapeutic monitoring without additional cost.

 
Keywords: anaemia, reticulocyte parameters, MRV, IRF, RSF, diagnostic haematology
     
Research Article: Original Paper | Subject: Pathology
Received: 2025/10/20 | Accepted: 2026/06/6
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