Lab Med Qual Assur.  2021 Sep;43(3):138-142. 10.15263/jlmqa.2021.43.3.138.

Clinical Utility of Reticulocyte Hemoglobin Equivalent in Diagnosing Iron Deficiency Anemia

• Park KJ
• Kim MJ

• KMID: 2520821
• DOI: http://doi.org/10.15263/jlmqa.2021.43.3.138

Abstract

Background
Iron deficiency anemia (IDA) is one of the major global public health problems. Reticulocyte hemoglobin (Hb) equivalent (Ret-He) has been proposed as an early index for IDA. However, little information is available regarding the Ret-He in Korean patients with IDA. We aimed to investigate the clinical utility of Ret-He as a diagnostic index in Korean patients with IDA.
Methods
Laborator y data, including complete blood count and iron metabolism markers, were retrospectively reviewed. In total, 507 individuals were categorized into four groups based on Hb and iron index: iron deficiency (ID, n=21), IDA (n=254), non-IDA (n=150), and healthy control (HC, n=82). Receiver operating characteristic analysis was performed to evaluate the diagnostic power of Ret-He.
Results
The Ret-He levels from the ID and IDA groups were significantly lower than those from the non-IDA and HC groups (P-value <0.0001; median Ret-He: 32.2 pg for ID; 29.7 pg for IDA; 33.9 pg for non-IDA; and 34.5 pg for HC). The area under the curve of Ret-He was 0.851 at a cutoff of 32.3 pg, by which IDA was discriminated from HC (sensitivity of 72% and specificity of 90%).
Conclusions
This study suggests that Ret-He could be an alternative hematologic index for the diagnosis of IDA. Further prospective clinical studies are warranted to validate the clinical utility of Ret-He and to integrate it into the diagnostic algorithm for IDA.

Keyword

Reticulocyte hemoglobin equivalent; Ferritina; Iron-deficiency anemia; Anemia; Korean