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Tytuł:
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Using Reticulocyte Hemoglobin Equivalent as a Marker for Iron Deficiency and Responsiveness to Iron Therapy.
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Autorzy:
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Auerbach M; Department of Medicine, Georgetown University School of Medicine, Washington, DC.
Staffa SJ; Department of Anesthesia, Boston Children's Hospital, Boston, MA.
Brugnara C; Department of Laboratory Medicine, Boston Children's Hospital, and Department of Pathology, Harvard Medical School, Boston, MA. Electronic address: .
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Źródło:
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Mayo Clinic proceedings [Mayo Clin Proc] 2021 Jun; Vol. 96 (6), pp. 1510-1519. Date of Electronic Publication: 2021 May 02.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Jan. 2012- : [Oxford, England] : Elsevier
Original Publication: Rochester, MN : Mayo Foundation for Medical Education and Research
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MeSH Terms:
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Anemia, Iron-Deficiency/*diagnosis
Hemoglobins/*analysis
Iron Compounds/*therapeutic use
Reticulocytes/*chemistry
Aged ; Anemia, Iron-Deficiency/blood ; Anemia, Iron-Deficiency/drug therapy ; Biomarkers/blood ; Blood Cell Count ; Female ; Ferritins/blood ; Humans ; Infusions, Intravenous ; Iron Compounds/administration & dosage ; Iron Compounds/blood ; Male ; Transferrin/analysis ; Treatment Outcome
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Substance Nomenclature:
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0 (Biomarkers)
0 (Hemoglobins)
0 (Iron Compounds)
0 (Transferrin)
9007-73-2 (Ferritins)
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Entry Date(s):
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Date Created: 20210506 Date Completed: 20210623 Latest Revision: 20210623
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Update Code:
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20240104
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DOI:
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10.1016/j.mayocp.2020.10.042
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PMID:
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33952394
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Objective: To assess the accuracy of a simplified approach for the diagnosis of iron deficiency anemia (IDA) based on the complete blood cell count (CBC) and reticulocyte analysis.
Patients and Methods: Five hundred fifty-six consecutive, nonselected patients referred for diagnosis and/or treatment of anemia were included in this diagnostic study to compare the performance of reticulocyte hemoglobin equivalent (RET-He) versus traditional biochemical markers for diagnosis and treatment of IDA. Complete blood count, serum ferritin, iron, and transferrin saturation were performed as clinically indicated. Reticulocyte hemoglobin equivalent was measured with a Sysmex XN-450 analyzer on the residual CBC sample. The study period was from September 20, 2017, through and including November 15, 2018.
Results: Patients (N=556) were studied at baseline, of whom 150 were subsequently treated with intravenous iron. Receiver operating characteristic analysis yielded an RET-He cut-off of 30.7 pg to identify IDA (area under curve, 0.733; 95% CI, 0.692 to 0.775), with 68.2% sensitivity and 69.7% specificity. Patients (n=240) were seen at follow-up, with 57 treated and 183 not treated with intravenous iron. Responsiveness was defined as a hemoglobin increase of ≥1.0 g: a combination of RET-He <28.5 pg and hemoglobin value <10.3 g/dL had 84% sensitivity and 78% specificity as response predictor (area under the curve, 0.749; 95% CI, 0.622 to 0.875).
Conclusion: Data from CBC and RET-He can identify patients with IDA, determine need for and responsiveness to intravenous iron, and reduce time for therapeutic decisions. Limitations of this study are uncontrolled design, its single-site and retrospective nature, and that it requires prospective validation.
(Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
