The haematological emergency - Anaemia and erythrocytosis - Calendar 2008 month 6

Scattergram from a 7-year old girl with pronounced hypochromic anaemia. In the reticulocyte channel the mean signal of the forward scatter of the reticulocytes (see arrow) correlates very well with their mean haemoglobin content (Ret-H_e). Compared to a healthy individual, in this patient a clear shift of the reticulocyte (purple and red) and the erythrocyte scatter signals (blue) to lower levels can be observed

Three days after initiating erythropoietin and i.v. iron therapy a clear increase of the reticulocyte count and Ret-H_e can be observed (red and purple signals shifted up: see arrow). The mature erythrocytes (blue) still demonstrate the initial iron deficiency.

Often pronounced erythrocytosis (polyglobulia) can already be recognised after sedimentation of the erythrocytes. Left tube: haematocrit 82%, right tube: haematocrit 39%.

In severe anaemia (here severe aplastic anaemia with haemoglobin of 4.8 g/dL) or in erythrocytosis with haematocrit above 50% it is difficult to prepare a proper blood film, with the blood film being either too thin (anaemia) or too thick. In cases of erythrocytosis it might be necessary to dilute the blood sample beforehand.