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

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.