Evaluation of RET-He values as an early indicator of iron deficiency anemia in pregnant women

Abstract Introduction During pregnancy, women are at an increased risk of developing iron-deficiency anemia. Objective The objective of this study was to assess the diagnostic performance of the reticulocyte hemoglobin equivalent (RET-He) in the early detection of iron-deficiency anemia in a group of pregnant women and to establish a reference range for this parameter in a group of control individuals. Method: A total of 60 patients and 130 control subjects were included in the study. Blood samples collected from the subjects were submitted to a complete blood count and a serum ferritin test and the data were analyzed by comparing the groups and ROC curves. Results The reference range found for the RET-He was between 29.75pg and 38.24pg, with a median of 35pg. The receiver operating characteristic (ROC) curve analysis for the ferritin parameter showed an area under the curve of 0.732 for the RET-He, 0.586 for hemoglobin, 0.551 for the mean corpuscular hemoglobin concentration and 0.482 for the mean corpuscular volume. Conclusion Early diagnosis of iron deficiency anemia in pregnancy is essential to prevent damage to both maternal and fetal health. The RET-He presents an excellent potential as an auxiliary tool for the diagnosis of iron deficiency in pregnant women.

Assessment of Reticulocyte-haemoglobin Equivalent (Ret-He) as a Diagnostic Indicator for Iron Deficiency Anaemia

@#Introduction: Iron deficiency anaemia (IDA) is the most common cause of anaemia. The diagnosis of IDA, however, remains a challenge and is a problem worldwide. Serum iron study is commonly used for IDA diagnosis but there are some limitations. This study was conducted to evaluate reticulocyte-haemoglobin equivalent (Ret-He) as a screening tool for IDA diagnosis in adults. Method: This is a comparative case control study conducted in Hospital Tengku Ampuan Afzan, Kuantan consisting of adult patients with iron deficiency anaemia and a healthy control group. Haematological parameters (Hb, RBC count, MCV, MCH, RDW) inclusive of Ret-He and serum iron parameters (serum iron, transferrin saturation and serum ferritin) were measured. Correlation between Ret-He with other haematological and serum iron parameters were analysed. Results: There were 103 IDA adult patients with majority of them being female (85.4%) with median age of 36 years old. Malay ethnicity (79.6%) contributed to the larger proportion of adult IDA patients. The Ret-He value for patient and control groups were 16.50 ± 4.90 pg and 34.80 ± 1.97 pg, respectively. Ret-He was 89.32% sensitive and 100% specific with 100% positive predictive value (PPV) and 73.11% negative predictive value (NPV) when compared to transferrin saturation. There was significant correlation between Hb, MCH, MCV, RDW and serum iron, transferrin saturation and serum ferritin parameters with Ret-He. Conclusion: Ret-He together with a complete blood count, may serve as an alternative to the serum iron parameters for screening of IDA in adults.