Abstract
Diagnostics of Iron deficiency anemia (IDA) in outpatient pediatric practice is often based on decreased hemoglobin level. Latent iron deficiency diagnostic is not a part of current routine practice.Objective. To study the diagnostic value of red blood cell indices and reticulocyte hemoglobin equivalent in diagnostics of iron deficiency in full-term infants.Children characteristics and research methods. A prospective cohort study of healthy full-term children aged from 6 to 12 months at the children hospitals of Samara and Tolyatti. The laboratory examination included a general blood test to determine the concentration of hemoglobin, the number of red blood cells, red blood cell indices, and reticulocyte hemoglobin equivalent (Ret-He); to determine serum ferritin and C-reactive protein. The AUC (area under the curve) was used to determine the diagnostic value of quantitative indicators. The children with anemia without iron deficiency and children who received iron supplements within 1 month prior to laboratory examination were excluded from the analysis.Results. The study involved 207 children. When diagnosing iron deficiency in children, the highest AUC was found in Ret-He: 0.747 [0.679; 0.816] in 6-months-old children and 0.790 [0.708; 0.871] in 1-year-old children. The Ret-He diagnostic value was higher in children with iron deficiency: AUC 0.826 [0.754; 0.898] in 6- months-old children and 0.865 [0.809; 0.920] in 1-year-old children.Conclusion. Ret-He is a better predictor of iron deficiency in children under 1 year as compared to the red blood cell indices. The diagnostic value of red blood cell indices and Ret-He is higher in case of iron deficiency anemia than in case of iron deficiency conditions.
Highlights
Diagnostics of Iron deficiency anemia (IDA) in outpatient pediatric practice is often based on decreased hemoglobin level
The laboratory examination included a general blood test to determine the concentration of hemoglobin, the number of red blood cells, red blood cell indices, and reticulocyte hemoglobin equivalent (Ret-He); to determine serum ferritin and C-reactive protein
When diagnosing iron deficiency in children, the highest AUC was found in Ret-He: 0.747 [0.679; 0.816] in 6-months-old children and 0.790 [0.708; 0.871] in 1-year-old children
Summary
Диагностика железодефицитной анемии в амбулаторной педиатрической практике часто основана только на выявлении снижения уровня гемоглобина, а диагностика латентного дефицита железа в повседневной практике не проводится. Оценка диагностической ценности индексов эритроцитов и содержания гемоглобина в ретикулоцитах для установления дефицита железа у доношенных детей первого года жизни. Показатель Ret-He продемонстрировал большую диагностическую ценность в скрининге дефицита железа у детей первого года жизни по сравнению с индексами эритроцитов. Диагностическая ценность содержания гемоглобина в ретикулоцитах при установлении дефицита железа у доношенных детей первого года жизни. The Ret-He diagnostic value was higher in children with iron deficiency: AUC 0.826 [0.754; 0.898] in 6- months-old children and 0.865 [0.809; 0.920] in 1-year-old children. Диагностическая ценность содержания гемоглобина в ретикулоцитах при установлении дефицита железа у доношенных. В качестве скрининговых методов используются клинические признаки дефицита железа и железодефицитной анемии, определение уровня гемоглобина в крови и эритроцитарных индексов. Цель исследования: изучить диагностическую ценность определения индексов эритроцитов и содержания гемоглобина в ретикулоцитах для установления дефицита железа у доношенных детей первого года жизни
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