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Reticulocyte hemoglobin content for the diagnosis of iron deficiency in young children with acute infection

Korean Journal of Pediatrics 2008;51(8):827-833.
Published online August 15, 2008.
Reticulocyte hemoglobin content for the diagnosis of iron deficiency in young children with acute infection
Jon Soo Kim, Jun Seok Choi, Doo Young Choi, Chur Woo You
Department of Pediatrics, College of Medicine, Eulji University, Daejeon, Korea
급성 감염성 질환을 가진 영유아에서 철결핍 진단 지표로서의 망상적혈구혈색소량
김존수, 최준석, 최두영, 유철우
을지대학교 의과대학 소아과학교실
Correspondence: 
Chur Woo You, Email: ycw1@eulji.ac.kr
Abstract
Purpose
: Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection.
Methods
: We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL.
Results
: In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all).
Conclusion
: CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.
Key Words: Iron deficiency anemia, Reticulocyte hemoglobin content, Iron deficiency indices


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