DIAGNOSIS OF IRON DEFICIENCY ANEMIA IN THAI FEMALE ADOLESCENTS USING RETICULOCYTE HEMOGLOBIN EQUIVALENT

  • Natthawadi Thimthong Faculty of Allied Health Sciences, Thammasat University
  • Apichat Photi-a Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine
  • Chanchai Traivaree Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine
  • Dollapak Apipongrat Division of Hematology, Department of Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine
  • Oytip Nathalang Faculty of Allied Health Sciences, Thammasat University
Keywords: Iron deficiency anemia, Reticulocyte, Hemoglobin, Reticulocyte hemoglobin equivalent, Thai female adolescents

Abstract

Background: Female adolescents aged 10 to 19 years are at remarkable risk of iron deficiency anemia (IDA). Reticulocyte hemoglobin equivalent (Ret-He) is an initial indicator of iron incorporation in red blood cells (RBCs) hemoglobin and reflects the iron functional availability in the RBCs.

Objective: This study aimed to assess the diagnostic performance of Ret-He to identify IDA and determine a specific cut-off value for Thai female adolescents.

Methods: Blood samples of 191 Thai female adolescents, ages ranging from 12 to 18 years, were included. Patients underwent complete blood count, reticulocyte count, Ret-He, serum iron (SI), total iron-binding capacity (TIBC), and transferrin saturation (TSAT). The correlation of Ret-He with other parameters and the diagnostic performance to identify IDA were evaluated.

Results: Among 191 patients, 89 and 102 were defined as IDA and non-IDA groups. Ret-He value in the IDA group was significantly lower than that in the non-IDA group (p<0.001). Strong positive correlations were observed between Ret-He and RBC indices and SI and TSAT (p<0.001). A Ret-He value of ≤27.0 pg could distinguish IDA from non-IDA with a sensitivity of 91.2% and a specificity of 100.0% (area under the curve, AUC of 0.99, 95% CI: 0.98-0.99; p<0.001).

Conclusion: This study confirmed that Ret-He is a cost-effective parameter representing an advantage over other traditional iron markers. A specific Ret-He cut-off value of ≤27.0 pg is suitable for distinguishing IDA from non-IDA with excellent diagnostic performance among Thai female adolescents.

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Published
2022-09-18
How to Cite
1.
Thimthong N, Photi-a A, Traivaree C, Apipongrat D, Nathalang O. DIAGNOSIS OF IRON DEFICIENCY ANEMIA IN THAI FEMALE ADOLESCENTS USING RETICULOCYTE HEMOGLOBIN EQUIVALENT. J Southeast Asian Med Res [Internet]. 2022Sep.18 [cited 2022Oct.7];60:e0126. Available from: https://www.jseamed.org/index.php/jseamed/article/view/126
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