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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level

Published on: January 19, 2024

Reticulocyte Hemoglobin Equivalent (Ret-He) as a Marker of Iron Deficiency Anemia in Acutely Ill Hospitalized

Madhumati Suhas Otiv1, Sarita Verma2, Suman Garag1

  • 1Department of Pediatrics, K.E.M Hospital and Research Center, Rasta Peth, Pune, 411011, India.

Indian Journal of Pediatrics
|June 19, 2026
PubMed

Insights

Reticulocyte hemoglobin equivalent (Ret-He) is a superior diagnostic marker for iron deficiency anemia (IDA) in acutely ill children compared to serum ferritin. This study highlights Ret-He

Area of Science:

  • Pediatric Hematology
  • Diagnostic Biomarkers
  • Anemia Research

Background:

  • Iron deficiency anemia (IDA) is a common condition in acutely ill children.
  • Accurate and timely diagnosis is crucial for effective management.
  • Serum ferritin is a traditional marker, but its utility can be affected by inflammation.

Purpose of the Study:

  • To evaluate the diagnostic utility of reticulocyte hemoglobin equivalent (Ret-He) for identifying IDA in acutely ill hospitalized children.
  • To compare the diagnostic performance of Ret-He with serum ferritin.
  • To determine optimal cut-off values for both markers in this pediatric population.

Main Methods:

  • Patients were categorized into IDA, non-anemia-iron-deficiency (NAID), and normal groups after excluding confounding conditions.
  • Diagnostic utility indices, including sensitivity, specificity, and predictive values, were calculated for Ret-He and serum ferritin.
  • Receiver-operating-characteristic (ROC) curve analysis was used to determine optimal cut-off points.

Main Results:

  • Ret-He levels were significantly lower in the IDA group compared to other groups (p < 0.001).
  • Serum ferritin levels did not show a significant difference between groups (p = 0.062).
  • Ret-He demonstrated higher sensitivity (87.2%) and specificity (80.9%) for IDA detection compared to serum ferritin (58.8% and 66.7%, respectively).

Conclusions:

  • Ret-He exhibits superior diagnostic utility for identifying IDA in acutely ill hospitalized children compared to serum ferritin.
  • The optimal cut-off for serum ferritin in this cohort was higher than the WHO reference standard.
  • Ret-He serves as a valuable and potentially more reliable biomarker for IDA diagnosis in this clinical setting.
Abstract

Keywords:
Acutely ill childrenIron deficiency anemiaRDW indexReticulocyte hemoglobin

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