Reticulocyte hemoglobin content in the diagnosis of iron deficiency anemia

The aim of the study was to examine the clinical utility of the reticulocyte hemoglobin content (CHr) in relation to the mean cell volume of the erythrocyte (MCV) and ferritin for the differential diagnosis of iron-deficient anemia (IDA). In 96 anemic patients classified according to morphology of erythrocytes, CHr indicated a high statistical difference between the non-anemic control group and microcytic (p < 0.001) and normocytic (p < 0.001) anemic groups, but was limited in patients with macrocytic anemia, for which reason they were excluded from the study. In the inflammatory disorders, ferritin concentration may be normal or increase due to acute phase response, which provides false information on a patient's iron status, but CHr indicated a high statistical difference between the control group and the non-inflammatory (p < 0.001) and inflammatory groups (p < 0.001). Receiver operator characteristic curve analysis demonstrates that CHr has a better overall sensitivity and specificity than MCV and ferritin in the diagnosis of iron deficiency compared to hemoglobin concentration.