Background: Thrombocytopenic disorders are a wide-ranging group of diseases and ailments that cause a decrease in platelet count. Diagnosing these disorders can be difficult because they often have similar symptoms and causes. In the assessment of thrombocytopenia, reticulated platelets—immature platelets discharged into circulation—have proven to be useful indicators. Critical insights into the underlying causes of thrombocytopenia—whether due to poor production, increased destruction, or sequestration—are provided by these platelets, which represent bone marrow activity and platelet turnover. Immune thrombocytopenia, bone marrow failure syndromes, consumptive coagulopathies, and other thrombocytopenic illnesses are discussed in this study, along with the diagnostic possibilities of reticulated platelets. Flow cytometry and automated platelet analyzers are two examples of modern technologies that have improved the clinical utility of reticulated platelets by allowing for their accurate measurement. Current diagnostic methods that use reticulated platelet indices are also covered in the study, along with their limitations and their consequences for prognosis and therapy monitoring.

Conclusion: In the assessment of thrombocytopenic diseases, the presence or absence of reticulated platelets can differentiate between peripheral platelet destruction (e.g., ITP) and reduced production as a result of bone marrow failure (e.g., MDS, AA). While automated RP measurement is a time- and labor-saving technology, there are still some analytical systems where its accuracy is questionable. In addition to providing light on the pathogenesis of different platelet diseases, monitoring RP levels may act as an early marker of bone marrow recovery post-transplant.