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CPE-011 · Classification
AN-03: Marrow response
Marrow response. Evaluates reticulocyte percentage and hematocrit available.
Condition
- reticulocyte percentage and hematocrit available
What it reports
- Corrected reticulocyte count = reticulocyte % × (hematocrit ÷ 45)
- Reticulocyte production index = corrected count ÷ maturation factor
- RPI of 2 or more: appropriate marrow response (blood loss, hemolysis or recovery); below 2: inadequate response
Diagnostic boundary
- Interpret with the clinical context.
Evidence
- EV-TEFFERI-2003Tefferi A. Anemia in adults: a contemporary approach to diagnosis. Mayo Clin Proc. 2003;78(10):1274-1280.Supports: Classification by MCV and reticulocyte response; first-line studies
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
ANEM-FX-01
Microcytic anemia with low ferritin
A 36-year-old, Hb 9.9, MCV 72, ferritin 6, TSAT 7%.
ANEM-FX-02
Microcytic anemia, normal iron indices and a low Mentzer index
MCV 62, RBC 5.7.
ANEM-FX-03
Macrocytic anemia with low B12 and hypersegmented neutrophils
MCV 112.
ANEM-FX-04
Hemolysis: reticulocytes 12%, LDH 640, haptoglobin 5
Spherocytes and a positive DAT.
ANEM-FX-05
Anemia in CKD
eGFR 28, normocytic, low reticulocytes, iron replete.
ANEM-FX-06
Anemia of inflammation
CRP 30, ferritin 340, TSAT 12%.
ANEM-FX-08
Schistocytes with platelets 40
A thrombotic microangiopathy pattern.
ANEM-FX-10
Hemoglobin fell from 13.2 to 9.8
A fall of 3.4 g/dL.
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