Diagnostic Test Equivalent Hemoglobin Reticulocyte in Iron Deficiency Anemia
Abstract
BACKGROUND: Diagnosing iron deficiency anemia (IDA) is easy, but also can be complicated in condition with inflammation. A new modality for diagnostic which isn’t influenced with inflammation is needed. The aim of this study is to find the cut-off point and evaluate the accuracy of reticulocyte hemoglobin equivalent (Ret-He) to diagnose IDA using ferritin as the gold standard.
METHODS: This study was an observational study with cross-sectional analytical design continued with the diagnostic test conducted in anemic individuals with age 18 years old or above.
RESULTS: Eighty-seven patients (41 men and 46 women) were included in this study with mean of hemoglobin 7.42 g/dL, serum iron 42.71 mg/dL, total iron-binding capacity (TIBC) 242.82 mg/dL, ferritin 799 ug/L and Ret-He 23.63 pg. Ret-He with cut-off value 25 pg showed a sensitivity 97.2% (95% CI 83.79-99.85%), specificity 66.67% (95% CI 51.97-78.85%), positive predictive value 67.30% (95% CI 52.77-79.28%) and negative predictive value 97.14% (95% CI 83.38-99.85%).
CONCLUSION: Ret-He showed the best sensitivity for detection of IDA and was suggested as the screening test for IDA.
KEYWORDS: IDA, Ret-He, diagnostic test
Full Text:
PDFReferences
World Health Organization [Internet]. Geneva: World Health Organization; 2005. Worldwide prevalence on Anemia 1993-2005 [cited: 2015 Jun 15]. Available from: http://www.who.int/.
Departemen Kesehatan RI [Internet]. Jakarta: Balai Penelitian dan Pengembangan Kesehatan Departemen Kesehatan RI. Riset; 2008. Kesehatan Dasar (RISKESDAS) 2007. Available from: https://www.k4health.org/.
Suega K, Dharmayuda TG, Sutarga IM, Bakta IM. Iron-deficiency anemia in pregnant women in Bali, Indonesia: a profile of risk factors and epidemiology. Southeast Asian J Trop Med Public Health. 2002; 33: 604-7, PMID.
Brugnara C. Iron deficiency and erythropoiesis: new diagnostic approaches. Clin Chem. 2003; 49: 1573-8, CrossRef.
Bakta IM. Anemia hipokromik mikrositer dengan gangguan metabolisme besi. In: Hematologi klinik ringkas. Jakarta: Penerbit Buku Kedokteran EGC; 2006. p. 26-44.
Thomas C, Thomas, L. Biochemical markers and hematologic indices in the diagnosis of functional iron deficiency. Clin Chem. 2002; 48 :1066-76, PMID.
Mast AE, Blinder MA, Dietzen DJ. Reticulocyte hemoglobin content. Am J Hematol. 2008; 83: 307-10, CrossRef.
Brugnara C. A hematologic "gold standard" for iron-deficient states?. Clin Chem. 2002; 48: 981-2, PMID.
Mast AE, Blinder MA, Lu Q, Flax S, Dietzen, DJ. Clinical utility of the reticulocyte hemoglobin content in the diagnosis of iron deficiency. blood. 2002; 99: 1489-91, PMID.
Swart PDR, Rautenbach K, Raubenheimer JE. Reticulocyte haemoglobin content as a diagnostic tool for iron deficiency and iron deficiency anaemia in ill infants and children. SAJCH. 2014; 8:23-27, article.
Urrechaga E, Izquierdo S, Escanero JF. Looking back to our roots: 80 years of wintrobe’s indices. EMJ Hema. 2014; 1: 133-7, article.
Brugnara C, Schiller B, Moran J. Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states. Clin Lab Haematol. 2006; 28: 303-8, CrossRef.
Urrechaga E, Borque L, Escanero JF. Potential utility of the new sysmex XE 5000 red blood cell extended parameters in the study of disorders of iron metabolism. Clin Chem Lab Med. 2009; 47: 1411-6, CrossRef.
Canals C, Remacha AF, Sarda MP, Piazuelo JM, Royo MT, Romero MA. Clinical utility of the new sysmex XE 2100 parameter-reticulocyte hemoglobin equivalent-in the diagnosis of anemia. Haematologica. 2005; 90: 1133-4, PMID.
Hatoun J, Sobota A, Meyers A. Using reticulocyte hemoglobin equivalent to screen for iron deficiency may be problematic. Glob Pediatr Health. 2014. 1: 2333794X14557030, CrossRef.
DOI: https://doi.org/10.18585/inabj.v9i3.267
Copyright (c) 2017 The Prodia Education and Research Institute
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Indexed by:
The Prodia Education and Research Institute
