Comparison of erythrocyte and reticulocyte indices for the diagnosis of iron deficiency
DOI:
https://doi.org/10.6016/ZdravVestn.2403Keywords:
iron defciency anemia, erythrocyte and reticulocyte indices, anemia in chronic kidney diseaseAbstract
Background: Te increased prevalence of iron defciency anemia represents a global public health issue which can be reduced by early diagnosis of pre-iron defcient states. Clinical utility of biochemical indices for iron defciency diagnosis is limited due to the influence of inflammation. Erythrocyte and reticulocyte indices, reticulocyte hemoglobin content, and percentage of hypochromic red cells have been extensively used in diagnosing different iron-defcient conditions. Te aim of our study was to compare the utility of erythrocyte and reticulocyte indices provided by different hematology analyzers for the diagnosis of iron defciency.
Methods: 186 people, 25 patients with iron defciency anemia, 103 patients with chronic kidney disease, and 58 healthy donors were included in our study. Teir whole blood samples were analyzed using two different automated analyzers, XN-1000, Sysmex and Advia 120, Siemens Bayer Diagnostics, to compare reticulocyte and erythrocyte indices.
Results: Linear correlation between indices for hemoglobin reticulocyte content (Ret-He and CHr) has been confrmed while correlation between both erythrocyte indices (Hypo-He and %HYPO) can be described by 2nd degree polynomial. Cut-off value for the diagnosis of iron defciency for Ret-He was established at < 28.2 pg and for Hypo-He at > 1.6 % and showed high diagnostic sensitivity (RetHe = 76 %; Hypo-He = 72 %) and specifcity (100 %).
Conclusions: Reticulocyte indices Ret-He and CHr are directly comparable and can be used for latent iron defciency evaluation. Although erythrocyte indices Hypo-He and %HYPO are not exchangeable, both can be used for long-term iron defciency evaluation. Additionally, we determined reference intervals for Hypo-He and Ret-He.
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