The paediatric iron deficiency assessment with reticulocyte haemoglobin equivalent (Ret-He) in comparison with biochemical markers of serum ferritin and transferrin saturation
Diagnosis of iron deficiency anaemia (IDA) is a challenge as the conventional methods often diagnose the disease at the later stage. Haemoglobin content of reticulocytes is useful to identify IDA at earlier stage. The objective of this study was to evaluate reticulocyte-haemoglobin equivalent...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Pusat Perubatan Universiti Kebangsaan Malaysia
2021
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| Online Access: | http://journalarticle.ukm.my/18272/ http://journalarticle.ukm.my/18272/1/10_ms0501_pdf_20599.pdf |
| Summary: | Diagnosis of iron deficiency anaemia (IDA) is a challenge as the conventional
methods often diagnose the disease at the later stage. Haemoglobin content of
reticulocytes is useful to identify IDA at earlier stage. The objective of this study
was to evaluate reticulocyte-haemoglobin equivalent (Ret-He) in diagnosing IDA
in children and to compare it with other conventional methods. This prospective
study was conducted on 120 paediatric patients aged 12 years and below, who
attended Hospital Sultanah Aminah Johor Bahru, Malaysia with haemoglobin <12
g/dL. Ret-He and serum iron, ferritin and transferrin saturation were measured.
Using a cut-off point of 20% for transferrin saturation, 81 out of 120 subjects
(67.5%) were found as iron deficient. Based on the diagnosis of IDA, cut-off value
for Ret-He using the Receiver Operating Characteristics (ROC) curve analysis was
found as 22.65 pg. Ret-He showed a good sensitivity and specificity of 77.8% and
66.7%, respectively. As compared with Ret-He, serum ferritin showed a sensitivity
of only 18.9%. However, a good specificity of 100% suggest it is useful for ruling
in the disease but not suitable for screening. Transferrin saturation showed a good
sensitivity and specificity, but it is biologically variable and not cost effective as
a screening tool. Correlation study showed serum iron and transferrin saturation
have significant positive correlation with Ret-He (r=0.415 to 0.518). However, there
was no correlation between Ret-He and serum ferritin (r=0.051, p=0.578). This
study shows that Ret-He at a cut-off point of 22.65 pg has a better sensitivity and
potentially be useful as a screening tool in the paediatric population. |
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