QUANTITATIVE AND QUALITATIVE EVALUATION OF RETICULOCYTES IN ACUTE-PANCREATITIS

The goal of the study was to determine whether reticulocyte modificati ons occur in the course of acute pancreatitis and to assess whether an y such modifications correlate with the severity of the disease. Quali tative and quantitative changes in these cells were evaluated in the c ourse of acute pancreatitis and these results were compared with leuko cyte counts, hemoglobin concentration, serum C-reactive protein (CRP) and calcium concentrations, and other biochemical tests. Thirteen pati ents were studied: 8 men (mean age, 53.5 years; range, 17 to 80 years) and 5 women (mean age, 59.5 years; range, 47 to 75 years). Two of the men had alcoholic necrotizing pancreatitis, one of whom died; the rem aining 11 patients had acute edematous pancreatitis (of biliary origin in 10, and secondary to benign stenosis of the papilla in 1). In the patients with biliary acute pancreatitis in whom an increase in leukoc yte and CRP concentrations was demonstrated, there was a concomitant r ise in the percentage of young and especially middle-aged reticulocyte s in the late phase of the disease, even when the total reticulocyte c ount remained unchanged. In these patients, a concomitant decrease in hemoglobin was observed. In the two alcoholic patients, both the total reticulocyte count and the percentage of young and middle-aged reticu locytes were slightly increased at the onset of illness. In the patien t who died (on day 3 of illness), the total reticulocyte count and ret iculocyte percentages remained essentially unchanged until his death, and the serum CRP concentration was low during these 3 days. In the ot her alcoholic patient there was a progressively slight increase in the percentage of middle-aged reticulocytes, and a moderate rise in CRP l evel, which peaked on day 3 of illness. These data suggest that evalua ting the quantitative and qualitative modifications of reticulocytes m ay aid in assessing the severity of acute pancreatitis; these modifica tions may be different in alcoholic and biliary acute pancreatitis.