Reticulocyte count

How the Test is Performed:
Adult or child:
Blood is drawn from a vein ( venipuncture ), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding .

Infant or young child:
The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

A special stain can be used to identify reticulocytes, because they contain remnants of RNA. Fully mature red blood cells are terminally-differentiated cells lacking nuclei, mitochondria, and nucleic acids. The number of reticulocytes in the blood is proportional to their rate of synthesis and release by the bone marrow. The body will respond to bleeding or hemolytic anemia by an increased rate of synthesis, if all available nutrients are present. A lower-than-normal percentage of reticulocyte is suggestive of a nutritional deficiency.

How to Prepare:
Adults:
No special preparation is necessary.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:



How it Feels:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing .

Risks:

  • excessive bleeding
  • fainting or feeling lightheaded
  • hematoma (blood accumulating under the skin)
  • infection (a slight risk any time the skin is broken)
  • multiple punctures to locate veins



Why this Test is Performed:
To determine if red blood cells are being created in the bone marrow at a normal rate.

Normal Values:
0.5% to 2%

Abnormal Results:
A greater-than-normal percentage of reticulocytes may indicate:

A lower-than-normal percentage of reticulocytes may indicate:

Additional conditions under which the test may be performed:



Cost:
The estimated cost is $20.

Special Considerations:
The reticulocyte count may be increased by pregnancy .

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.


In the presence of some anemias, the body increases production of red blood cells (RBCs), and sends these cells into the bloodstream before they are mature. These slightly immature cells are called reticulocytes, and are characterized by a network of filaments and granules. Reticulocytes normally make up 1% of the total RBC count, but may exceed levels of 4% when compensating for anemia.