New erythrocyte and reticulocyte parameters: Indicators for early diagnosis of iron deficiency anemia and anemia of chronic disease

Abstract

Introduction: Iron deficiency anemia (IDA) is a global health burden with an increasing prevalence in children and adult females. Traditionally, absolute iron deficiency has been based on low serum iron and ferritin. In recent years, the development of new automated hematologyanalyzers has paved the way for analysis of new parameters for mature red blood cells and reticulocytes in diagnosis of anemia. Materials and methods: Blood samples of adult females of reproductive age group (15-45 years) were collected and processed within 6 hours of collection. Based on hematological and biochemical findings, patients were segregated into four subgroups: Iron deficiency anemia (IDA, n = 40), Anemia of chronic disease (ACD, n=40), Latent iron deficiency (n=40) and Controls (n=40). Observations and results: The novel hematological parameters- Reticulocyte hemoglobin content (Ret-He), percentage of microcytic red blood cells (MicroR), hemoglobin content of erythrocytes (RBC-He) and percentage of hypochromic erythrocytes (HypoHe) had a statistically significant difference between the four groups (p < 0.05). The correlation between reticulocyte indices and iron parameters depicted that levels of Ret-He among all study participants (160) increased as the serum iron and serum ferritin increased indicating a significant positive correlation. Ret-He and RBC-He demonstrated better predictive power as per area under curve of ROC as compared to MicroR and HypoHe indices for latent anemia identification. Conclusion: The present study emphasized upon the importance of novel and cost effective routine new parameters in early and accurate diagnosis of IDA and ACD. Moreover Ret-He emerged as a sensitive and specific marker for diagnosis of latent iron deficiency.

Keywords

• anemia of chronic disease
• iron deficiency anemia
• latent iron deficiency
• ret-he
• rbc-he