Red Blood Cell Fragility and Reticulocyte Count in Hemolytic Anemic Patients with and Without G-6PD Enzyme Deficiency

Abstract

Background: Erythrocyte G-6PD enzyme deficiency is an important cause of Hemolytic anemia with consequent increase in reticulocyte count. Objective: To assess the osmotic fragility of RBC status and reticulocyte count in G-6PD enzyme deficient patients with hemolytic anemia in order to find their hemolytic status. Methods: The cross sectional study was carried out in the Department of Physiology, BSMMU, Dhaka from July 2002 to June 2003 to observe the osmotic fragility of RBC status and reticulocyte count in patients with hemolytic anemia. For this, total number of 50 hemolytic anemic patients (Group-B) with age ranged from 5 to 30 years of both sexes were studied. Among them, 25 were without G-6PD deficient hemolytic anemia (group-B 1 ) and 25 were hemolytic anemia with G-6PD enzyme deficiency (group-B 1 ). Age & sex matched 30 apparently healthy subjects with normal blood G-6PD level were included to observe the baseline data (Group-A) and also for comparison. All the subjects were selected from Out Patient Department of Hematology, Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka. Blood erythrocyte G-6PD enzyme level, osmotic fragility of RBC & reticulocyte count were measured by standard laboratory techniques. Analysis of data was done by unpaired Student 't' test. Result: Mean starting & completing points of hemolysis of RBC were significantly higher in Group B 2 vs Group A and also with Group B 1 and similar higher levels of these values were also observed in Group B 1 than those of Group A, but the differences between them were not statistically significant. Reticulocyte count was significantly higher in Group-B 2 vs Group B 1 and also with Group A and similar higher levels of this values were also observed in Group B 1 vs Group A which was also statistically significant. Conclusion: From this study, it may be concluded that, increased hemolysis of RBC with higher reticulocyte count occur in G-6PD deficient hemolytic anemic patients which may be due to membrane defect. Key words: Osmotic fragility; Reticulocyte count; G-6PD enzyme; Hemolytic anemia. DOI: 10.3329/bsmmuj.v3i1.5510 BSMMU J 2010; 3(1): 23-26