Article Sidebar

Submitted
November 5, 2025
Accepted
May 20, 2026
Published
May 31, 2026
Download
Statistic
Read Counter : 4

Downloads

Download data is not yet available.

Main Article Content

Abstract

Background: Iron Deficiency Anemia (IDA) remains a significant health concern among adolescent females. Reliable and effective parameters are required for the monitoring of anemia. Reticulocyte, reported as absolute reticulocyte count or reticulocyte percentage, is a valuable parameter for assessing the degree of effective erythropoiesis in anemia cases. Establishing appropriate reference values is essential for accurate interpretation of reticulocyte measurements.
Objective: This study aimed to establish reference intervals for reticulocyte parameters specifically in adolescent females using the Sysmex XN-1000 hematology analyzer.
Method: A peripheral blood sample was collected from female high school students aged 14-19 years who were not menstruating at the time of sampling. Blood collection was done via venipuncture into K3-EDTA tubes and further analyzed using the Sysmex XN-1000 hematology analyzer.
Results: The established reference intervals were as follows: reticulocyte percentage (Ret%) 0.665–2.099%; absolute reticulocyte count (Ret#) 0.0312–0.0977 × 10⁶/µL; and reticulocyte hemoglobin (Ret-He) 26.524–32.574 pg. Data were normally distributed (p > 0.05). Reference intervals were calculated using the formula mean ± 1.96 standard deviation, with a 95% confidence level.
Conclusion: This study successfully established specific reference intervals for reticulocyte parameters in adolescent females using the Sysmex XN-1000 hematology analyzer.

Keywords

Reticulocyte Sysmex XN-1000 adolescent females anemia

Article Details

License

Copyright (c) 2026 Tri Ratnaningsih, Surawijaya Bakhtiar Kaslam, Pranindya Rinastiti

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish in the Jurnal Ilmiah Farmasi agree to the following terms:

  1. Authors retain copyright and grant Jurnal Ilmiah Farmasi right of first publication with the work simultaneously licensed under a Creative Commons Attribution Licence that allows others to adapt (remix, transform, and build) upon the work non-commercially with an acknowledgement of the work's authorship and initial publication in Jurnal Ilmiah Farmasi.
  2. Authors are permitted to share (copy and redistribute) the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in Jurnal Ilmiah Farmasi.
Crossref
Scopus
Google Scholar
Europe PMC

References

  1. Aedh, A.I., Khalil, M.S.M., Abd-Elkader, A.S., El-Khawanky, M.M., Alshehri, H.M., Hussein, A., Alghamdi, A.A.L., Hasan, A., 2023. Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off. Hematol. Rep. 15, 201.
  2. Bildirici, M.A., Gülten, S., Çalışgan, N.C., 2023. Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000. Turkish Journal of Biochemistry 48, 388–396.
  3. Buttarello, M., Rauli, | A, Mezzapelle, | G, 2017. Reticulocyte count and extended reticulocyte parameters by Mindray BC-6800: Reference intervals and comparison with Sysmex XE-5000. Int J Lab Hem 1–8.
  4. Cai, J., Wu, M., Ren, J., Du, Y., Long, Z., Li, G., Han, B., Yang, L., 2017. Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults. Nutrients 2017, Vol. 9, Page 450 9, 450.
  5. CLSI, 2010. Clinical and Laboratory Standards Institute. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory: Approved Guideline – Third Edition., Third edition. ed. Wayne, PA, USA.
  6. Halterman, J.S., Segel, G.B., 2023. Iron Deficiency Anemia. Pediatric Clinical Advisor 31–31.
  7. Kementrian Kesehatan RI, 2019. Laporan Riskesdas 2018 Nasional.
  8. Kılıç, M., Özpınar, A., Serteser, M., Kilercik, M., Serdar, M., 2022. The effect of reticulocyte hemoglobin content on the diagnosis of iron deficiency anemia: A meta-analysis study. J. Med. Biochem. 41, 1–13.
  9. L. Van Pelt, J., Klatte, S., Hwandih, T., Barcaru, A., Riphagen, I.J., Linssen, J., Bakker, S.J.L., 2022. Reference intervals for Sysmex XN hematological parameters as assessed in the Dutch Lifelines cohort. Clin. Chem. Lab. Med. 60, 907–920.
  10. Marks, P., Glader, B., 2009. Approach to Anemia in the Adult and Child. In: Hoffman, P., Benz, E., Shattil, S. (Eds.), Hematology: Basic Principles and Practice. Churchill Livingstone, Philadelphia .
  11. Munro, M.G., Mast, A.E., Powers, J.M., Kouides, P.A., O’Brien, S.H., Richards, T., Lavin, M., Levy, B.S., 2023. The relationship between heavy menstrual bleeding, iron deficiency, and iron deficiency anemia. Am. J. Obstet. Gynecol. 229, 1–9.
  12. Paltrinieri, S., Fossati, M., Menaballi, V., 2017. Diagnostic performances of manual and automated reticulocyte parameters in anaemic cats. J. Feline Med. Surg. 20, 122.
  13. Parodi, E., Romano, F., Ramenghi, U., 2020. How We Use Reticulocyte Parameters in Workup and Management of Pediatric Hematologic Diseases. Front. Pediatr. 8, 588617.
  14. Posada-Franco, Y., García-Álvarez, A., Hernández-Álvarez, E., Serrano-García, I., Contera-Raposo, R., Martínez-Novillo González, M., Sanz-Casla, M.T., 2024. Reference intervals for reticulocyte count and derived reticulocyte parameters in a cohort of healthy adults. Int. J. Lab. Hematol. 46, 997–1003.
  15. Prchal, J., 2021. Erythropoiesis and Red Cell Turnover. In: Kaushansky, K., Prchal, J. (Eds.), Williams Hematology. McGraw-Hill, New York.
  16. Rai, D., Wilson, A.M., Moosavi, L., 2023. Histology, Reticulocytes. StatPearls.
  17. Rana, F., Sinha, A., Mishra, M., Narayan, R., 2026. Diagnostic Utility of Reticulocyte Hemoglobin Equivalent in Iron-Deficiency Anemia: An Observational Study From Eastern India. Cureus 18, e101429.
  18. Ringoringo, H.P., Purnamasari, L., Yunanto, A., Syahadatina, M., Hidayah, N., 2023. Reference range of complete blood count, Ret-He, immature reticulocyte fraction, reticulocyte production index in healthy babies aged 1–4 months. Sci. Rep. 13, 423.
  19. Russo, G., Guardabasso, V., Romano, F., Corti, P., Samperi, P., Condorelli, A., Sainati, L., Maruzzi, M., Facchini, E., Fasoli, S., Giona, F., Caselli, D., Pizzato, C., Marinoni, M., Boscarol, G., Bertoni, E., Casciana, M.L., Tucci, F., Capolsini, I., Notarangelo, L.D., Giordano, P., Ramenghi, U., Colombatti, R., 2020. Monitoring oral iron therapy in children with iron deficiency anemia: an observational, prospective, multicenter study of AIEOP patients (Associazione Italiana Emato-Oncologia Pediatrica). Ann. Hematol. 99, 413–420.
  20. Sari, P., Judistiani, R.T.D., Hilmanto, D., Herawati, D.M.D., Dhamayanti, M., 2022. Iron Deficiency Anemia and Associated Factors Among Adolescent Girls and Women in a Rural Area of Jatinangor, Indonesia. Int. J. Womens Health 14, 1137.
  21. Scherer, P.S., Moraes, D., Munhoz, T.P., Sgnaolin, V., 2015. New red blood cell and reticulocyte parameters and reference values for healthy individuals and in chronic kidney disease. J. Bras. Patol. Med. Lab. 51, 77–84.
  22. Sedick, Q., Elyamany, G., Hawsawi, H., Alotaibi, S., Alabbas, F., Almohammadi, M., Alahmari, H.A., Aljasem, H., Ferrer, A.G., Alzahrani, A.S., AlMoshary, M., Alsuhaibani, O., 2021. Diagnostic accuracy of reticulocyte parameters on the sysmex XN 1000 for discriminating iron deficiency anaemia and thalassaemia in Saudi Arabia. Am. J. Blood Res. 11, 172.
  23. Thimthong, N., Photi-a, A., Traivaree, C., Apipongrat, D., Nathalang, O., 2022. Diagnosis of Iron Deficiency Anemia in Thai Female Adolescents Using Reticulocyte Hemoglobin Equivalent. Journal of Southeast Asian Medical Research 6, e0126–e0126.
  24. Tung, K.T.S., Chen, C., Chiu, Y.T., So, H.K., So, C.C., Ip, P., 2024. Reference values for reticulocyte haemoglobin equivalent in healthy Chinese children under 5 years and its associations with various blood parameters. BMJ Paediatr. Open 8.