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

Tiwari, Aseem Kumar; Bhardwaj, Gunjan; Arora, Dinesh; Aggarwal, Geet; Pabbi, Swati; Dara, Ravi C; Sachdev, Ritesh; Raizada, Arun; Sethi, Monisha

doi:10.1111/vox.12700

Cited by 23 publications

(27 citation statements)

References 18 publications

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“…37 Retic-Hb is reported to be a more reliable marker of iron restriction than sTfR in healthy blood donors. 38 An early indicator of response to iron therapy in IDA is provided by a rising Retic-Hb on day 4, 39 similar to the observation of a falling percentage of hypochromic red cells in response to therapy. 40 An algorithm for the diagnostic approach to IDA is suggested in figure 1.…”

Section: Guidelinesmentioning

confidence: 82%

British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults

Snook

Bhala

Beales

et al. 2021

Gut

132

111

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Iron deficiency anaemia (IDA) is a major cause of morbidity and burden of disease worldwide. It can generally be diagnosed by blood testing and remedied by iron replacement therapy (IRT) using the oral or intravenous route. The many causes of iron deficiency include poor dietary intake and malabsorption of dietary iron, as well as a number of significant gastrointestinal (GI) pathologies. Because blood is iron-rich it can result from chronic blood loss, and this is a common mechanism underlying the development of IDA—for example, as a consequence of menstrual or GI blood loss.Approximately a third of men and postmenopausal women presenting with IDA have an underlying pathological abnormality, most commonly in the GI tract. Therefore optimal management of IDA requires IRT in combination with appropriate investigation to establish the underlying cause. Unexplained IDA in all at-risk individuals is an accepted indication for fast-track secondary care referral in the UK because GI malignancies can present in this way, often in the absence of specific symptoms. Bidirectional GI endoscopy is the standard diagnostic approach to examination of the upper and lower GI tract, though radiological scanning is an alternative in some situations for assessing the large bowel. In recurrent or refractory IDA, wireless capsule endoscopy plays an important role in assessment of the small bowel.IDA may present in primary care or across a range of specialties in secondary care, and because of this and the insidious nature of the condition it has not always been optimally managed despite the considerable burden of disease— with investigation sometimes being inappropriate, incorrectly timed or incomplete, and the role of IRT for symptom relief neglected. It is therefore important that contemporary guidelines for the management of IDA are available to all clinicians. This document is a revision of previous British Society of Gastroenterology guidelines, updated in the light of subsequent evidence and developments.

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Section: Guidelinesmentioning

confidence: 82%

British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults

Snook

Bhala

Beales

et al. 2021

Gut

132

111

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“…Twari et al (13) demonstrated that RET-He might be a suitable marker for indicating latent iron deficiency in blood donors. Toki et al (9) found RET-He to be a useful marker in the diagnosis of overt iron deficiency anemia.…”

Section: Discussionmentioning

confidence: 99%

The importance of RET-He in the diagnosis of iron deficiency and iron deficiency anemia and the evaluation of response to oral iron therapy

Uçar¹,

Falay²,

Dağdas³

et al. 2019

Journal of Medical Biochemistry

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SummaryBackgroundThe purpose of this study is to investigate whether or not reticulocyte hemoglobin equivalent (RET-He) is a superior indicator of blood count and other iron parameters in terms of diagnosing iron deficiency (ID) and iron deficiency anemia (IDA), and thus evaluating a patient’s response to oral iron treatment.MethodsThe research population consisted of 217 participants in total: 54 control, 53 ID, 58 non-ID anemia, and 52 IDA patients. A hemoglobin (Hb) value of < 130.0 g/L was defined as indicating anemia for men, while an Hb value of < 120.0 g/L was defined as indicating anemia for women. All patients were administered 270 mg oral elemental iron sulphate daily.ResultsThe RET-He was significantly lower in the IDA group, compared to other groups (IDA: 21.0 ± 4.1, ID: 26.0 ± 4.9, non-ID anemia: 32.1 ± 6.8, control: 36.6 ± 7.0; < 0.001). The ID group had a lower RET-He compared to the non-ID anemia group and the control group. On the 5th day of treatment, the ID and IDA group showed no significant differences in terms of Hb while the RET-He level demonstrated a significant increase. The increase in the RET-He level observed in the IDA group on the 5th day was significantly higher compared to the increase observed in the ID group. A RET-He value of 25.4 pg and below predicted ID diagnosis with 90.4% sensitivity and 49.1% specificity in IDA patients, compared to the ID group.ConclusionsThe results of our study, therefore, suggest that RET-He may be a clinically useful marker in the diagnosis of ID and IDA.

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“…In adults, the Ret-He has already been proposed as an additional marker to screen for ID [8,[11][12][13][14][15][16]. For example, Toki et al revealed that Ret-He may be associated with ID by a sensitivity of 92.0% and a specificity of 81.0% (area under the curve (AUC) = 0.902) using a Ret-He cut-off value of ≤30.9 pg in adults [17].…”

Section: Introductionmentioning

confidence: 99%

The Reticulocyte Hemoglobin Equivalent as a Screening Marker for Iron Deficiency and Iron Deficiency Anemia in Children

Neef

Schmitt

Bader

et al. 2021

JCM

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Background: Iron deficiency (ID) is one of the most common nutritional deficiencies in children worldwide and may result in iron deficiency anemia (IDA). The reticulocyte hemoglobin equivalent (Ret-He) provides information about the current availability of iron in erythropoiesis. This study aims to examine the validation of Ret-He as a screening marker for ID and IDA in children. Methods: Blood samples were retrospectively obtained from medical records. Anemia was defined according to the definition provided by the World Health Organization (WHO) for children. ID was defined by transferrin saturation (TSAT) < 20% and ferritin < 100 ng/mL. Children were classified into four groups: IDA, non-anemia iron deficiency (NAID), control and others. Results: Out of 970 children, 332 (34.2%) had NAID and 278 (28.7%) presented with IDA. Analysis revealed that Ret-He significantly correlates with ferritin (rho = 0.41; p < 0.001), TSAT (rho = 0.66; p < 0.001) and soluble transferrin receptor (sTfR) (rho = −0.72; p < 0.001). For ROC analysis, the area under the curve (AUC) was 0.771 for Ret-He detecting ID and 0.845 for detecting IDA. The cut-off value for Ret-He to diagnose ID was 33.5 pg (sensitivity 90.7%; specificity 35.8%) and 31.6 pg (sensitivity 90.6%; specificity 50.4%) to diagnose IDA. Conclusions: The present study demonstrates Ret-He to be a screening marker for ID and IDA in children. Furthermore, Ret-He can be used as a single screening parameter for ID and IDA in children without considering other iron parameters. Economically, the use of Ret-He is highly relevant, as it can save one blood tube per patient and additional costs.

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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

Abstract: 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.

Cited by 23 publications

References 18 publications

British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults

British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults

The importance of RET-He in the diagnosis of iron deficiency and iron deficiency anemia and the evaluation of response to oral iron therapy

The Reticulocyte Hemoglobin Equivalent as a Screening Marker for Iron Deficiency and Iron Deficiency Anemia in Children

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