Is analysis of the reticulocyte haemoglobin equivalent a useful test for the diagnosis of iron deficiency anaemia in geriatric patients?

Etienne Joosten, Pieter Lioen, Caroline Brusselmans, Christophe Indevuyst, Nancy Boeckx

Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. etienne.joosten@uzleuven.be

European journal of internal medicine 2013 Jan

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Iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are common in elderly patients but there are no standard diagnostic criteria. The reticulocyte haemoglobin equivalent (Ret-He) is routinely measured by modern automated blood analysers and is an early indicator of iron deficiency. The aim of this study was to investigate whether the Ret-He level as calculated by the Sysmex XE-5000 automated blood analyser is a useful parameter for the diagnosis of IDA in a geriatric hospitalized population. In a prospective study, blood samples were collected in 26 geriatric patients with IDA and 111 patients with ACD diagnosed according to generally accepted laboratory and clinical criteria. A blood count including Ret-He, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and standard iron parameters was performed in each patient. Haemoglobin, Ret-He, MCV, MCH and MCHC levels were all significantly lower in IDA as compared to ACD patients. However, the area under the curve (AUC) was greater for MCH (0.87, 95% CI 0.78-0.95) and MCHC (0.86, 95% CI 0.76-0.96) then for Ret-He (0.828, 95% CI 0.73-0.93) and MCV (0.80, 95% CI 0.68-0.91). A Ret-He cut-off value of 26 pg had a sensitivity and specificity based on its optimal combination of 85% and 69% respectively. Analysis of Ret-He does not perform better than the classical red cell indices such as MCH and MCHC in differentiating IDA and ACD in geriatric patients. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Citation

Etienne Joosten, Pieter Lioen, Caroline Brusselmans, Christophe Indevuyst, Nancy Boeckx. Is analysis of the reticulocyte haemoglobin equivalent a useful test for the diagnosis of iron deficiency anaemia in geriatric patients? European journal of internal medicine. 2013 Jan;24(1):63-6