Reticulocytosis in screen-printing workers exposed to 2-butoxyethanol and 2-ethoxyethanol

BACKGROUND: Studies on the hematologic toxicity of ethylene glycol ethers in humans are limited. Therefore, the aim of this study was to examine the association between exposure to solvents (containing 2-butoxyethanol and 2-ethoxyethanol) and hematological effects. METHODS: Thirty-four screen-printing workers who were exposed to 2-butoxyethanol and 2-ethoxyethanol and 37 non-exposed clerical workers were selected using data from the health care facilities that provided regular health screening services. Student's t-tests and Pearson's chi-square tests were used to compare differences in hematological parameters between the exposed and the control groups. A multivariate analysis was performed using the multiple logistic regression models to adjust for other variables. RESULTS: The chi-square test showed the reticulocyte percentages and corrected reticulocyte counts to be significantly higher in the exposed group. The t-tests showed a significant increase in white blood cell counts, reticulocyte percentages, and corrected reticulocyte count (i.e., reticulocyte index) in the exposed group, with p-values of 0.002, 0.004, and 0.002, respectively. Multivariate analysis showed the odds ratio for the corrected reticulocyte counts to be 16.30 for the exposed group, when compared with that of the control group. CONCLUSIONS: Exposure to 2-butoxyethanol and 2-ethoxyethanol was significantly associated with reticulocytosis, necessitating the implementation of preventive measures for workers prone to occupational exposure to ethylene glycol ethers.

Myelodysplastic Syndrome with Delayed Maturation of Reticulocytes: A Report of Three Cases / 대한임상병리학회지

Anemia in myelodysplastic syndrome (MDS) is accompanied by reticulocytopenia in most patients. Reticulocytosis, when present, is generally less than appropriate to the degree of anemia and rarely exceeds 10%. In this report, three patients with MDS with persistent reticulocytosis are presented. In vitro reticulocyte survival studies have suggested that the reticulocytosis was caused by delay in maturation of the reticulocytes. Anemia with reticulocytosis, mimicking hemolytic disease, may be an unusual presentation of myelodysplastic syndrome, but, we emphasize that MDS should be included in the differential diagnosis of every patient presenting with anemia and high reticulocyte count. In vitro reticulotye survival study is easy to assess and valuable to diagnose this disease entity.

A Case of Coexistence with Myelodysplastic Syndrome and Paroxysmal Nocturnal Hemoglobinuria: Confirmed by Reticulocytes Survival Test and Glycosylphosphatidylinositol (GPI)-linked Protein Test / 대한혈액학회지

A patient presenting paroxysmal nocturnal hemoglobinuria (PNH) cloned cells in the course of myelodysplastic syndrome (MDS) with reticulocytosis is described. The bone marrow biopsy demonstrated erythroid hyperplasia and moderate dysplasia. Mild hemoglobinuria was detected but the Ham test was negative. The reticulocyte survival test revealed sustained survival curve indicating delayed reticulocyte maturation regarded as the characteristic of MDS cloned erythroid cells. The glycosylphosphatidylinositol-linked protein deficient neutrophils and erythrocytes population regarded as PNH clones were identified by flow cytometric analysis using monoclonal antibody. From these results, we concluded that MDS and PNH cloned cells were coexisited in this patient. In this patient, long-term follow-up observation could clarify whether MDS and PNH were arising from the same clone or from two distinct clones.