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Reticulocyte haemoglobin content as a diagnostic tool for iron deficiency and iron-deficiency anaemia in ill infants and children

P D Riekert Swart, Karlien Rautenbach, J E Raubenheimer

Abstract


Background. The diagnosis of iron deficiency (ID) and iron-deficiency anaemia (IDA) in ill children is complicated by the unreliability of serum ferritin (S-ferritin). The presence of a microcytic, hypochromic anaemia suggests IDA but is not specific. There is a need for a diagnostic test that will be accessible, cost-effective and accurate for the diagnosis of ID in ill children. Studies done in healthy children have reported that reticulocyte haemoglobin content (CHr) is a reliable diagnostic test for ID, eliminating the need for S-ferritin determination.

Objective. To evaluate the accuracy of CHr to diagnose ID and IDA in ill infants and children.

Methods. A prospective, descriptive study was conducted. One hundred children, aged 6 months to 6 years, who were admitted to Pelonomi Regional Hospital, Bloemfontein, South Africa, during July 2012 and August 2012 were included. 

Results. The study group was divided into an iron-deficient group and an iron-sufficient group based on transferrin saturation (TfS). A statistically significant difference was found between mean corpuscular haemoglobin (MCH), serum transferrin and CHr in these two groups (p=0.0001). The sensitivity of a CHr level ≤29 pg to detect ID was 86%, and the specificity was 50%.

Conclusion. CHr is an accurate diagnostic test for ID, and for IDA in combination with a low haemoglobin level, in ill infants and children.


Authors' affiliations

P D Riekert Swart, Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa

Karlien Rautenbach, Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa

J E Raubenheimer, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa

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Keywords

Iron deficiency; iron-deficiency anaemia; reticulocyte haemoglobin content; serum ferritin

Cite this article

South African Journal of Child Health 2014;8(1):23-27. DOI:10.7196/SAJCH.645

Article History

Date submitted: 2013-08-05
Date published: 2014-02-05

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