Reticulocyte haemoglobin as a diagnostic marker and its response towards oral iron therapy in paediatric iron deficiency anaemia

Abstract

Background: Iron deficiency anaemia (IDA) in the paediatric age group is prevalent in developing countries like India, especially in the lower socio-economic strata. Early detection and management will prevent the associated morbidity and mortality. Reticulocyte haemoglobin (Ret-Hb) is an indirect assessment of Hb content of reticulocytes by automated haematology analysers. Aims: The present study was aimed to evaluate the diagnostic efficacy of Ret-Hb in paediatric IDA and its prognostic efficacy by detecting early response to oral iron supplementation. Materials and Methods: This was an institutional prospective, cross-sectional study. Eighty-two cases of microcytic hypochromic anaemia, in the age group of 1–14 years negative for haemoglobinopathy by high-performance liquid chromatography, constituted the study group. Ret-Hb and serum ferritin (SF) values were correlated with other haematological parameters on day 0 and day 3 after oral iron supplementation and results obtained were statistically correlated. Results: The mean values of Hb, mean corpuscular volume, mean corpuscular Hb, red cell distribution width-CV (RDW-CV), Ret-Hb and SF were found to be 8.32 ± 1.99 g/dL, 63.44 ± 7.01 fL, 19.25 ± 3.21 pg, 19.16 ± 2.87%, 20.36 ± 3.41 pg and 8.99 ± 1.85 mcg/dL respectively. The Ret-Hb and SF levels were found to be linearly positively correlated with all parameters except RDW-CV which was negatively correlated; a stronger association was noted with the former. After oral supplementation on Day 3, only Ret-Hb showed statistically significant change, i.e., 20.36 ± 3.41 pg to 21.35 ± 3.61 pg (P < 0.001). Conclusion: Ret-Hb was found to be a reliable parameter not only in diagnosing IDA in children but also in detecting early response to oral iron supplementation.