ABSTRACT
BACKGROUND: Preterm and low birth weight infants are at risk of iron deficiency. Reticulocyte hemoglobin concentration may be useful as a screening test to diagnose iron deficiency in preterm neonates. OBJECTIVE: To evaluate the accuracy and establish the reticulocyte hemoglobin concentration cutoff value for iron deficiency diagnosis in very low birth weight preterm neonates. METHOD: This study was conducted between May 2018 and March 2019 at Chiang Mai University Hospital. Preterm infants born at gestational age ≤34 weeks and birth weight ≤1500 g were enrolled. Blood samplings were obtained within the first 48 h of life. Iron deficiency was defined by using two or more of these following parameters: mean corpuscular volume <100 fL, transferrin saturation <16% and serum ferritin <30 µg/L. Neonatal anemia was defined as hemoglobin <15 g/dL. The optimum reticulocyte hemoglobin concentration cutoff values were performed by using predictive values and receiving operation characteristic analysis. RESULT: Fifty-seven preterm neonates were enrolled. Nine (15.7%) and three (5.3%) neonates had iron deficiency and iron deficiency anemia, respectively. The reticulocyte hemoglobin concentration cutoff value of <29 pg showed the optimum accuracy to diagnose iron deficiency in very low birth weight preterm neonates with sensitivity, specificity, positive and negative predictive values of 89%, 79%, 42% and 97%, respectively. CONCLUSION: Reticulocyte hemoglobin concentration can be used as a screening parameter to diagnose iron deficiency for VLBW preterm neonates. The optimum cutoff value which provided the acceptable accuracy was <29 pg.
Subject(s)
Anemia, Iron-Deficiency , Iron Deficiencies , Anemia, Iron-Deficiency/diagnosis , Ferritins , Hemoglobins/analysis , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Reticulocytes/chemistry , Reticulocytes/metabolismABSTRACT
The draining of the right superior vena cava (SVC) into the left atrium is a very rare anomaly of systemic vein drainage. This case report describes a term male infant presenting with central cyanosis diagnosed with right SVC drainage into the left atrium. The diagnosis was performed using conventional echocardiography and computed tomography angiography. Surgical correction with translocation of the right SVC to the right atrium was necessary to treat the symptom of cyanosis and prevent further complications, including brain abscesses and paradoxical embolization.
