His investigations revealed anemia with reticulocytopenia. He received a PRBC transfusion and was discharged.
(11) Amongst the 11 cases reported, only one case was on hydroxyurea, which could have contributed to both their susceptibility to parvovirus infection and the ensuing reticulocytopenia. (12) It is also noteworthy that all the 11 cases had high baseline hemoglobin [greater than or equal to] 8.0 g/dL levels denoting that they had no underlying chronic hyperhemolysis.
The combination of anemia, reticulocytopenia, hydrops fetalis, and a positive indirect Coombs test suggested Kell isoimmunization.
The combination of anemia, reticulocytopenia, and hydrops fetalis was thought to be consistent with Kell isoimmunization.
Known and possible causes of hemolytic anemia in association with malaria or antiparasitic therapy include blackwater fever, artemisinin-induced reticulocytopenia
, direct hemolytic effects of the drug, and drug-induced immune hemolytic anemia.
Evidences favouring B19 infection in eight NOBI cases were presence of reticulocytopenia
(in 5 of 7 cases tested), anemia (severe in one cases) and more importantly finding of free DNA in serum.
An increase in the retic count (reticuiocytosis) indicates an overactive bone marrow that is producing an increased amount of RBCs, while a decreased retic count (reticulocytopenia
) indicates an underactive bone marrow that is not producing RBCs at the normal rate.
Some of the presented patients had reticulocytopenia
. The cause of reticulocytopenia
in AIHA is not well known.
Patients present with pallor, weakness, lethargy, and reticulocytopenia
in their blood smears, and within 7 to 10 days they develop severe anemia requiring multiple transfusions (Gillette, 1993).
Chronic anemia is the result of a selective decrease in red cell precursors in the bone marrow that presents as reticulocytopenia
in the peripheral blood (56-58).
After initiation of rHuEPO, reticulocytopenia
and anemia continued for two weeks and she had to be transfused again (Figure 1).
Although ABO-incompatibility between donor and recipient does not appear to affect the outcome of HSCT in terms of incidence of graft rejection or delayed white blood cell or platelet engraftment, in a minority of major ABO-incompatible stem cell graft recipients, prolonged reticulocytopenia
and an increased transfusion requirement have been observed [13-16].