retic indices

1. DISSERTATION PROTOCOL

2. ROLE OF RETICULOCYTE INDICES
IN EVALUATION OF
PANCYTOPENIA
DR.MIDHAT AEJAZ
DISSERTATION FOR THE COURSE OF MD PATHOLOGY
GUIDE: DR. S R NIVEDITHA
PROFESSOR,DEPARTMENT OF PATHOLOGY
KEMPEGOWDA INSTITUTE OF MEDICAL SCIENCES,BANGALORE

3. INTRODUCTION
• Pancytopenia is a term used for the reduction in the count of red
blood cells,white blood cells and platelets.
• Identifying the underlying cause is challenging as there are wide
range of etiologies ( infections, drugs ,autoimmune,
hemophagocytosis and inherited conditions).
• The reticulocyte indices given by the automated cell counters are
found to help in assessing the bone marrow activity, thereby
categorising the various causes.

4. NEED FOR STUDY
• Pancytopenia - involves a wide number of causes primarily or
secondarily involving the bone marrow.
• Cornerstone for evaluation of pancytopenia is Bone marrow study
(BMA & BMBx)
• However, Reticulocyte indices generated by advance coulters can aid
in identifying the cause of pancytopenia in least invasive fashion.
• Also an algorithmic approach of various clinical,routine
hematologiical and reticulocyte indices can help in early diagnosis
and management of pancytopenia.

5. AIM AND OBJECTIVES
• Recording reticulocyte indices( Reticulocyte percentage, Immature
reticulocyte fraction,Mean reticulocyte volume) in pancytopenia.
• Correlation of the reticulocyte indices with the etiological factors of
pancytopenia.
• Formulate a diagnostic algorithm to categorise pancytopenia effectively.

6. SUBJECT OR MATERIAL
• STUDY DURATION- 18 months
• STUDY DESIGN- Cross sectional study
• SAMPLE SIZE-100
• SAMPLING METHOD-Purposive
• INCLUSION CRITERIA-
Samples with Hb<13.5g/dl in males ans<11.5g/dl in females,
Total leucocyte count<4000/cumm
Platelet count<1.5lakh/cumm
• EXCLUSION CRITERIA-
Hemolysed samples
Detailed clinical history not available
Patient who have received recent blood transfusion(<3 weeks)

7. METHODS AND PROCEDURES
• The study will be conducted in central laboratory ,Department of
pathology.
• Hundred cases of pancytopenia (irrespective of age and gender) will
be the study group after obtaining consent.
• The reticulocyte indices generated by SYSMEX XN-1000 auto
analyser will be noted .
• Relevant clinical details , biochemical investigations will be
documented and correlated with the reticulocyte indices.

8. APPROACH TO ETHICAL ASPECTS
• Patient’s confidentiality will be maintained.

9. THANK YOU