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Measurement of reticulocyte hemoglobin content to diagnose iron deficiency in Saudi children
Ahmad Fayez Bakr1, Gale Sarette
1Pediatrics and Neonatology Unit, University of Alexandria, Alexandria, Egypt. afb1963@hotmail.com
Insights
Reticulocyte hemoglobin content (CHr) effectively diagnoses iron deficiency anemia in Saudi children. This cost-effective method, using CHr levels below 26 pg, offers a viable alternative for diagnosing anemia in developing nations.
Area of Science:
- Pediatrics
- Hematology
- Clinical Diagnostics
Background:
- Iron deficiency anemia is prevalent in children, particularly in developing countries.
- Accurate diagnostic tools for pediatric iron deficiency and anemia are crucial but challenging.
- The utility of reticulocyte hemoglobin (Hb) content (CHr) in developing countries for diagnosing these conditions remains unclear.
Purpose of the Study:
- To evaluate the effectiveness of CHr in diagnosing iron deficiency and iron deficiency anemia in Saudi children.
- To determine if CHr is a suitable diagnostic method in a developing country context.
- To establish a reliable CHr cut-off value for identifying anemia.
Main Methods:
- Study involved 305 children suspected of anemia.
- Collected data included complete blood count, transferrin saturation (Tfsat), ferritin, circulating transferrin receptor (TfR), and CHr.
- Participants were categorized into iron deficiency, iron deficiency anemia, and control groups based on Tfsat and Hb levels.
Main Results:
- The anemic group exhibited significantly lower mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and CHr compared to controls.
- Iron deficiency group also showed significantly lower values than controls, excluding TfR and ferritin.
- CHr levels below 26 pg strongly correlated with anemic states.
Conclusions:
- CHr, combined with complete blood count, presents a cost-effective alternative for diagnosing iron deficiency and anemia in young children.
- A CHr cut-off level of 26 pg is a reliable indicator for identifying anemic conditions.
- This approach is particularly valuable for resource-limited settings in developing countries.
Abstract:
Iron deficiency and iron deficiency anemia are common conditions in children, especially in developing countries. It is often difficult for the pediatrician to know which indices should be used in the diagnosis of these conditions in children. Reticulocyte hemoglobin (Hb) content (CHr) has been shown to be an accurate indicator of anemia, however whether its use suits the situation in developing countries or not is unclear. The aim of this study was to evaluate the value and effectiveness of using CHr as a method to diagnose iron deficiency and iron deficiency anemia in Saudi children. The samples for the study were collected from 305 children suspected to have anemia. Complete blood count, transferrin saturation (Tfsat), ferritin, circulating transferrin receptor (TfR) and CHr were measured. Three groups were defined, iron deficiency (Tfsat <20%, Hb >11 g/dL; n=120), iron deficiency anemia (Tfsat <20%, Hb <11 g/dL; (n=73) and controls (Tfsat >20%; n=112). The anemic group had significantly lower macrocytic anemia (MCV), mean corpuscular hemoglobin (MCH) and CHr. All of the variables in the anemia group were significantly lower than those of the control group except for the ferritin level. Compared to the control group, the iron deficiency group also showed significantly lower values except for transferrin receptor and the ferritin levels. CHr levels of <26 pg correlated well with anemic states. CHr together with a complete blood count may provide an alternative to the traditional hematologic or biochemical panel for the diagnosis of iron deficiency and iron deficiency anemia in young children and is cost-effective in developing countries. A CHr cut-off level of 26 pg is considered to be a reasonable indicator of anemic states.
