Abstract

Assessment of treatment response is needed in the management of iron deficiency anemia (IDA). This study aims to analyze erythrocyte indices (MCH, MCV, MCHC) and Ret-He as indicators of IDA diagnosis and treatment response. A prospective cohort study in children ages 2-18 years old in orphanages throughout Makassar. Grouped into normal group and therapy group, consisting of IDA and iron deficiency groups. Elemental iron therapy 3mg/kg/day was given. Levels of MCV (fl), MCH (pg), MCHC (g/dL), and Ret-He (pg) were measured before and on the 8th day of therapy. The normality test of numerical variable data used the Kolmogorov-Smirnov test. The statistical test used the Mann-Whitney test, Wilcoxon Signed Rank test, and the Kruskal-Wallis test. Diagnostic value and cut-off determination using ROC curve analysis. Test results were significant if p<0.05. The sample consisted of 40 subjects each in both normal and therapy groups. The therapy group was divided into 7 IDA and 33 iron deficiency. ROC IDA curve on MCV obtained a cut-off of 76 fl, a sensitivity of 100%, a specificity of 95%, NPP of 77.8%, NPN of 100%, MCH obtained a cut-off of 25 pg, a sensitivity of 100%, 97.5% specificity of 97.5%, NPP of 87.5%, NPN of 100%, Ret-He obtained cut-off 29 pg, sensitivity of 100%, specificity of 95%, NPP of 77.5%, NPN of 100%. MCV levels increased by 7.3% (p<0.05) while Ret-He increased by 19.6% (p<0.05) after therapy. The ROC curve coordinate on IDA showed that cut-off levels of MCV 76 fl, MCH 25 pg, and Ret-He 29 pg provided optimal sensitivity and specificity. Increasing MCV after therapy described increasing levels in erythrocyte and hematocrit synthesis. Increasing Ret-He after therapy described improving erythropoiesis quality. MCV, MCH, and Ret-He as indicators of diagnosing IDA. MCV and Ret-He monitor the success of IDA treatment response.

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