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Applying newer parameter Ret‐He (reticulocyte haemoglobin equivalent) to assess latent iron deficiency (LID) in blood donors–study at a tertiary care hospital in India
Author(s) -
Tiwari Aseem K,
Bhardwaj Gunjan,
Arora Dinesh,
Aggarwal Geet,
Pabbi Swati,
Dara Ravi C,
Sachdev Ritesh,
Raizada Arun,
Sethi Monisha
Publication year - 2018
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/vox.12700
Subject(s) - medicine , soluble transferrin receptor , iron deficiency , ferritin , hemoglobin , serum iron , anemia , complete blood count , total iron binding capacity , gold standard (test) , gastroenterology , reticulocyte , immunology , surgery , iron status , biology , biochemistry , messenger rna , gene
Background It is important to detect Latent Iron Deficiency ( LID ) to prevent development of an overt iron deficiency anemia. Early detection is difficult by using conventional hematological and biochemical parameters. Soluble transferrin receptor ( sTfR ) is presently the gold standard for diagnosing LID . We evaluated the utility of Reticulocyte Hemoglobin Equivalent (Ret‐He), a newer hematological parameter, to predict LID in blood donors as compared to sTfR . Methods This was a randomized prospective study performed on 501 donor samples over a period of three‐months. All donors were included after administering medical history questionnaire and a brief physical examination in accordance with national guidelines (Hb ≥12.5). Additional samples were collected during donation according to the institutional standard operating procedure ( SOP ). All hemograms were performed on the Sysmex XE ‐2100 analyzer which included Ret‐He. sTfR was measured in batch assays by ELISA (Biovendor, Czech Republic). Ret He <28 pg and sTfR ≥3μg/ml were used to diagnose LID . Serum Iron, Total Iron Binding Capacity ( TIBC ) and Serum Ferritin were also measured simultaneously. Results Of the 501 blood donors, sTfR and Ret‐He detected LID in 148 and 135 donors respectively. In comparison to sTfR , Ret‐He had sensitivity of 92.7%, a specificity of 97.16%, PPV of 93.1% and NPV of 96.3%. Serum Ferritin, TIBC and serum Iron had comparatively lower sensitivity of 87.16%, 79.7% and 77.7% respectively. Conclusion Ret‐He can be used as a routine screening test to detect LID in blood donors. This could provide an opportunity to make appropriate and timely interventions like dietary changes or drug supplementation.