Narvestad-Bøttger H, Winther-Larsen A, Haugbølle Bjerre J, Dziegiel MH, Hansen AT, Hasle H. Extreme Reticulocytosis After Splenectomy in a Patient With Hemoglobin Mizuho.
J Pediatr Hematol Oncol 2024;
46:e111-e114. [PMID:
38011049 DOI:
10.1097/mph.0000000000002790]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND
Patients with Hb Mizuho may be splenectomized at a young age to decrease their need for blood transfusions.
OBSERVATIONS
Transfusion-dependency decreased dramatically in a 4-year-old white boy with Hb Mizuho after splenectomy. Surprisingly, he developed reticulocytosis (>1000×10 9 /L) with a peak reticulocyte percentage of 49%, and erythrocyte abnormalities, including Heinz bodies, Howell-Jolly bodies, and basophilic stippling. Manual reticulocyte counting and flow cytometric measurement with anti-CD71 antibodies supported a truly elevated reticulocyte count.
CONCLUSIONS
We propose possible explanations for the extreme reticulocytosis that arose postsplenectomy and compare the reticulocyte count in the present case with previously published cases.
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