Role of reticulocyte haemoglobin content in diagnosis of iron deficiency anaemia

Abstract

Background Multiple studies have demonstrated the value of detecting reticulocyte Hb (CHr) in peripheral blood samples for the diagnosis of iron insufficiency. It has been shown to be a reliable iron marker for gauging the efficacy of iron therapy and giving a precise assessment of iron status. Aim of work To improve the management of children with iron deficiency anaemia via evaluation of the significance of CHr in the diagnosis of IDA and comparing CHr with other iron parameters especially transferrin saturation and serum ferritin. Methods The study was a prospective, case-control study. It was conducted at the out-patient hematology clinic, pediatrics department, Zagazig University Hospital during six months from September 2022 to February 2023 after obtaining approval from Institutional Review Board (IRB #:9660-26-7-2022). Consecutive, non-selected 40 patients referred for anemia diagnosis were included in the study in addition to healthy 40 children of matched age and sex attending pediatric clinics for other causes than anemia who served as control group. All patients were subjected to full history taking, routine clinical examination, laboratory investigations including CBC and (CHr), iron parameters including serum iron, serum ferritin, TIBC, Transferrin saturation. Results The best cutoff of reticulocytes hemoglobin in diagnosis of anemia is ≥28.8%, area under curve 0.943, sensitivity 92.5%, specificity 82.5%, positive predictive value 84.1%, negative predictive value 91.7%, overall accuracy 87.5%. There is statistically highly significant difference between the studied groups regarding reticulocyte hemoglobin. Conclusion Our study demonstrates that CHr is a useful parameter that can be confidently used in the diagnosis of IDA. CHr can be a good predictor of IDA as evidenced by the correlations between the CHr and conventional haemtological and biochemical parameters of iron deficiency anemia.