Related Experiment Video
Updated: Jul 13, 2025
Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
Reticulocyte hemoglobin equivalent as a marker to assess iron deficiency: A large pediatric tertiary care hospital
Izmarie Poventud-Fuentes1,2, Thomas H Chong1,2, Michael Dowlin1,2
1Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA.
Insights
Reticulocyte hemoglobin equivalent (Ret-He) reliably confirms iron deficiency anemia (IDA) in children. This marker shows promise for diagnosing iron deficiency (ID) but requires further study for early-stage detection.
Area of Science:
- Hematology
- Pediatric Medicine
- Clinical Diagnostics
Background:
- Diagnosing iron deficiency (ID) presents significant clinical challenges.
- Reticulocyte hemoglobin equivalent (Ret-He) is explored as a novel diagnostic marker.
- Assessing Ret-He performance in a large pediatric cohort for ID and iron deficiency anemia (IDA) is crucial.
Purpose of the Study:
- To evaluate the diagnostic performance of Ret-He in identifying iron deficiency (ID) and iron deficiency anemia (IDA) in a pediatric population.
- To correlate Ret-He levels with established iron status parameters.
- To determine the sensitivity and specificity of Ret-He for diagnosing ID and IDA.
Main Methods:
- Retrospective analysis of 3158 pediatric patients (15 days to 19 years).
- Statistical evaluation of Ret-He correlation with complete blood count and iron panel parameters.
- Comparison of Ret-He levels between ID, IDA, and control groups, assessing diagnostic accuracy (sensitivity, specificity, AUC).
Main Results:
- Ret-He positively correlated with ferritin and transferrin saturation (TSAT).
- Significantly lower median Ret-He observed in ID patients.
- Ret-He demonstrated high sensitivity and specificity for IDA (90.1%, 80.9% at ≤27.4 pg) and acceptable performance for ID without anemia (80.8%, 51.1% at ≤30.8 pg).
Conclusions:
- Ret-He is a reliable marker for confirming IDA in pediatric patients.
- Further research is necessary to establish Ret-He's utility in detecting early-stage iron deficiency.
- The study supports Ret-He as a valuable tool in pediatric hematology diagnostics.
Introduction:
Detection of iron deficiency (ID) remains challenging. We aimed to evaluate the performance of reticulocyte hemoglobin equivalent (Ret-He) as a potential diagnostic marker to assess ID and iron deficiency anemia (IDA) in a large pediatric cohort.
Methods:
A total of 3158 patients (aged 15 days to 19 years with a median age of 8.5 years; 60.2% female) were retrospectively studied. Statistical analysis was performed (a) to evaluate relationship of Ret-He with other relevant complete blood count and iron panel parameters; (b) to compare the levels of Ret-He in ID and IDA groups to a control group; and (c) to assess sensitivity and specificity of Ret-He in ID, IDA, and anemia without ID groups.
Results:
Ret-He values were significantly positively correlated to ferritin and transferrin saturation (TSAT). The median Ret-He was significantly lower in ID. A Ret-He cutoff of ≤30.0 pg distinguished cases of ID from the control group with a sensitivity of 90.2%, specificity of 59.5%, and area under curve (AUC) of 0.88. Ret-He showed better diagnostic performance in the IDA group and acceptable performance for ID without anemia. The sensitivity, specificity, and AUC were 90.1%, 80.9%, and 0.93 for IDA at cutoff value of ≤27.4 pg, and 80.8%, 51.1%, and 0.70 for ID without anemia at cutoff value of ≤30.8 pg, respectively.
Conclusion:
Our large pediatric tertiary care hospital study demonstrates that Ret-He is a reliable marker to help confirm IDA in pediatric population. However, further studies are needed for its use to capture the early stages of ID.
More Related Videos
05:08Measurement of Tissue Non-Heme Iron Content using a Bathophenanthroline-Based Colorimetric Assay
Published on: January 31, 2022
08:53Author Spotlight: Advancing Erythropoiesis Research - A Simplified Pipeline for Assessing Hematopoietic Stem Cell Function in Myelodysplastic Syndromes
Published on: January 10, 2025
