TO STUDY CLINICAL SIGNIFICANCE OF RETICULOCYTE HAEMOGLOBIN CONTENT IN IRON DEFICIENCY ANEMIA

Background- Anemia is foremost health problem worldwide that need total elimination according to United Nation declaration 1997. Approximately 2 billion population suffer from iron deciency or anemia globally Worldwide (IDA) is the commonest form of nutritional anemia. 1 2 Various biochemical markers used for diagnosis of Iron deciency anemia are MCV, ferritin, transferrin saturation (TS) and serum iron . CHr 3 indicates availability of Iron for haemoglobin production in the bone marrow. Therefore, CHr has been proposed as marker of iron status in body 4 Several studies indicated that CHr measurement useful for IDA and reliable marker for monitoring iron therapy's efcacy and iron status in body. 5,6 7 that's why we needed this study to know the role of CHr in IDA. Our objectives were to evaluate the level of reticulocyte haemoglobin content in the diagnosis and treatment of iron deciency anemia Materials and Methods – A hospital based prospective study was undertaken at our tertiary care centre in the department of General Medicine, MGMs Medical College & Hospital Aurangabad on admitted patient , of patients with newly diagnosed and untreated Iron Deciency Anemia (mild-moderate) according to WHO criteria conrmed by iron studies were included. Results – In the study total 96 patients included amongst them 63.5 % were females and majority patients (35.5 %) were in the age group of 31-40 years. Reticulocyte Haemoglobin (CHr) showed a signicant positive correlation with haemoglobin (r=0.782; ), MCV (r=0.871; ), p<0.05 p<0.05 MCHC (r=0.685; ), MCH (r=0.879; ), serum iron (r=0.651; ), and % Saturation (r=0.702; ). CHr showed p<0.05 p<0.05 p<0.05 p<0.05 signicant negative correlation with TIBC (r=-0.613; ) and Ferritin (r=-0.604; ). p<0.05 p<0.05 Conclusion – CHr is a useful parameter that can be condently used in the diagnosis of Iron deciency anemia (IDA) and a CHr cut-off value predicts IDA. Ferric carboxymaltose was usually well tolerated and had a good impact in the management of iron-deciency anemia. After iron replacement therapy CHr values increased correlated with haemoglobin and iron level. We cannot replace iron study but CHr can be used for early diagnosis of Iron deciency anemia and in management of iron deciency.

Reticulocyte haemoglobin content: 2020 update

The hemoglobin content of reticulocytes (Hb-ret) is an effective real-time hemoglobin synthesis status indicator that permits diagnosis and monitoring of iron deficiency and iron deficiency anemia in all age groups with or without underlying diseases, including beta thalassemia. Hb-ret is less invasive than bone iron examination, less expensive than iron biochemical tests and might be available even in local laboratories. This review covers reports published mainly in 2020 and some other studies dedicated to clinical application of Hb-ret measured by Sysmex hematology analyzers.

Functional iron deficiency markers are absent during pregnancy despite evidence of low iron stores

Introduction Functional iron deficiency parameters predict iron-restricted erythropoiesis more precisely than ferritin. Ferritin and erythropoiesis can be affected by inflammation and hormonal alterations. We hypothesize that the association between low ferritin concentrations and iron-restricted erythropoiesis is not comparable between pregnant and non-pregnant women. Materials and methods Pregnant women ( n = 926) were included at week 12 of gestation. Ferritin concentrations, %hypochromic erythrocytes (%HYPO), %microcytic erythrocytes (%MICRO), reticulocyte haemoglobin content (MCHr), mean cell volume (MCV) and mean cell haemoglobin (MCH) were analysed. Data were compared with non-pregnant women ( n = 1302). Results Functional iron deficiency parameters (%HYPO, %MICRO, MCHr) were present in, respectively, 3.9%, 14.3% and 2.3% off all pregnant women. Univariate analysis of low ferritin (<20 μg/L) showed significant differences between non-pregnant versus pregnant women; %HYPO (10.92% vs. 0.92%), increased %MICRO (4.33% vs. 1.00%) and decreased MCHr (24.9 pg vs. 29.5 pg), respectively. In the logistic regression analysis, MCHr, %MICRO and MCV were independently associated with low ferritin concentrations in pregnant women, while %HYPO and %MICRO were independently associated variables in non-pregnant women with low ferritin concentrations. Discussion Functional iron deficiency is significantly less frequent in pregnant women compared with iron-deficient non-pregnant women. During pregnancy, iron metabolism might be differentially regulated for optimal fetal growth and development despite low maternal iron stores.