title: Temporary impairment of reticulocyte haemoglobin content in subjects with community-acquired pneumonia.
abstract: BACKGROUND
  In the case of inflammation, imbalance of iron homoeostasis is caused by increased retention of iron within cells of the reticuloendothelial system. Iron-restricted erythropoiesis occurs because of decreased availability of iron for haemoglobin (Hb) synthesis in erythroid progenitor cells. Deviations in reticulocyte haemoglobin (Ret-He) content are investigated together with inflammation markers in subjects with community-acquired pneumonia (CAP). Short-term alterations with regard to Ret-He during and after completing antibiotic treatment are investigated.
  
  
  METHODS
  A total of 75 patients, classified into three subgroups with CURB-65 scores of ≤1, 2 and ≥3, participated in the study.
  
  
  RESULTS
  Within the three subgroups, Hb results demonstrate a decline from the day of admission until day 4. From day 4, an increase towards higher values is observed at day 14. Within 24 h after admission, Ret-He results are situated within the lower quartile region of the reference range interval. Until day 4 of hospital admission, a steady trend towards a decline of 3-8% is established. During antibiotic treatment, an increase in reticulocyte count occurs from 0.039 ± 0.014 × 10(12) /L at day 4 to 0.057 ± 0.020 × 10(12) /L at day 14 (mean ± SD). Recovery of Hb and Ret-He occurs towards values within the reference range.
  
  
  CONCLUSIONS
  In subjects with CAP, acute inflammation results in impairment of Ret-He at an early stage. After onset of pneumonia, decreased results of Ret-He and Ret-He/RBC-He ratio are demonstrated, reflecting acute erythropoietic dysfunction, which are amongst others caused by functional iron depletion.
authors.affiliation: Department of Clinical Chemistry, Haematology & Immunology, Medical Center Alkmaar, Alkmaar, The Netherlands. m.g.schoorl@mca.nl
authors.forename: M
authors.initials: M
authors.lastname: Schoorl
authors.forename: D
authors.initials: D
authors.lastname: Snijders
authors.forename: M
authors.initials: M
authors.lastname: Schoorl
authors.forename: W G
authors.initials: WG
authors.lastname: Boersma
authors.forename: P C M
authors.initials: PC
authors.lastname: Bartels
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000150:complications; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006651:Histocytochemistry; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D017701:Reticulocyte Count; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D006454:Hemoglobins