Reticulocyte Haemoglobin Content as a Diagnostic Tool for Iron Deficiency and Iron-Deficiency Anaemia in Ill Infants and Children

ABSTRACT

Background. The diagnosis of iron deficiency (ID) and iron-deficiency anaemia (IDA) in ill children is complicated by the unreliability of serum ferritin (S-ferritin). The presence of a microcytic; hypochromic anaemia suggests IDA but is not specific. There is a need for a diagnostic test that will be accessible; cost-effective and accurate for the diagnosis of ID in ill children. Studies done in healthy children have reported that reticulocyte haemoglobin content (CHr) is a reliable diagnostic test for ID; eliminating the need for S-ferritin determination.Objective. To evaluate the accuracy of CHr to diagnose ID and IDA in ill infants and children.Methods. A prospective; descriptive study was conducted. One hundred children; aged 6 months to 6 years; who were admitted to Pelonomi Regional Hospital; Bloemfontein; South Africa; during July 2012 and August 2012 were included. Results. The study group was divided into an iron-deficient group and an iron-sufficient group based on transferrin saturation (TfS). A statistically significant difference was found between mean corpuscular haemoglobin (MCH); serum transferrin and CHr in these two groups (p=0.0001). The sensitivity of a CHr level ?29 pg to detect ID was 86; and the specificity was 50. Conclusion. CHr is an accurate diagnostic test for ID; and for IDA in combination with a low haemoglobin level; in ill infants and children