Defining an optimal cut-off point for reticulocyte hemoglobin as a marker for iron deficiency anemia: An ROC analysis

Abstract

Reticulocyte hemoglobin (CHr) is a measure of the amount of hemoglobin in reticulocytes and a marker of cell hemoglobinization. In this study, we aimed to find the optimal cut-off point for reticulocyte hemoglobin to diagnose iron deficiency anemia using multiple methods. A total of 309 patients were included. The median age at diagnosis was 54 years. Most were females (71.2%). 68% had iron deficiency anemia. Patients with IDA had significantly lower levels of CHr compared to those who had non-IDA (p < 0.0001). The optimal cut-off value of CHr for detecting IDA, determined using various methods, was 30.15 pg. This cut-off point had a sensitivity of 87.8% and a specificity of 77.7%. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, serum iron, serum ferritin, and transferrin saturation and a significant negative correlation with total iron-binding capacity. CHr levels correlate with most established laboratory tests for IDA. It reliably detects IDA. Our results indicate the importance of CHr in diagnosing IDA, and that CHr should be used more widely in suspected cases of IDA since it is a cheap, fast, and reliable test.

The mean reticulocyte volume is a valuable index in early diagnosis of cancer-related anemia

“…It has been clear that peripheral blood reticulocyte count is an important index in the diagnosis, classification, and monitoring of anemic patients ( Wollmann et al, 2014 ). Several reticulocyte maturity indices, such as immature reticulocyte fraction (IRF), reticulocyte production index (RPI), and reticulocyte hemoglobin (RHE) content, can be helpful in the diagnosis of pathologies, and in monitoring bone marrow recovery ( Wollmann et al, 2014 ; Cascio & De Loughery, 2017 ; Alzu’bi et al, 2023 ; Chang & Kass, 1997 ). Thus, the measurements of non-tradictional reticulocyte indices will be of notable significance in the early diagnosis of CRA.…”