Validity of red blood indices in screening for iron deficiency anemia in exclusively breast fed infants

Iron deficiency anemia [IDA] is a public health problem of widespread prevalence in developing countries. The rapidly growing infants are the most vulnerable to iron deficiency if they are not supplemented with sufficient iron during weaning. The aim of this work is to study the importance of red cell distribution width [RDW] and RDW-MCV [mean corpuscular volume] combination in the diagnosis of iron deficiency anemia. Infants within the age group 6-12 months who were exclusively breast fed for the first six months attending the pediatric outpatient clinic of Suez Canal University Hospital, Ismailia, were assessed for full nutritional history, general examination, hemoglobin level, MCV, mean corpuscular hemoglobin concentration [MCHC], RDW, serum ferritin [SF], serum iron [SI], transferrin saturation [Trns.S%] and total iron binding capacity [TIBC]. The study revealed that in the anemic blood group [based on a hemoglobin level less than 10 g/dL]. RDW had a high sensitivity, specificity and efficiency as a diagnostic test for IDA [83.3%, 67.2% and 86.6% respectively] and that RDW-MCV in combination were 95% sensitive, 83.3% specific and 92% efficient for the diagnosis of IDA. In conclusion, diagnosis of iron deficiency anemia can be made more accurately and with less expense by combining hemoglobin level measurement with MCV and RDW