ROLE OF RETICULOCYTE HEMOGLOBIN CONTENT IN DIAGNOSIS OF IRON DEFICIENCY ANEMIA

Objectives: Anaemia is a global problem of immense health significance affecting persons of all ages and economic groups. Iron deficiency anaemia (IDA) is the most common type of anaemia met with in clinical practice. For IDA diagnosis, estimation and treatment, many indices like serum iron (SI), total iron binding capacity (TIBC), serum ferritin (SF), soluble transferrin receptor assay are used. But reticulocyte haemoglobin content (CHr) is called as the gold standard for diagnosing IDA as it is the most valuable screening tool for identifying IDA with a sensitivity of 94% and specificity 80% and differentiates IDA from anaemia of systemic disease (ASD). The present study was undertaken to evaluate CHr as a most efficient marker in diagnosing IDA. Methods: This prospective observational study was carried out in the Department of General Medicine of M.K.C.G. Medical College and hospital, Berhampur, Odisha, India from October 2017 to October 2019. Sixty microcytic hypochromic patients of either sex >18 yrs of age admitted in the medicine ward fulfilling the inclusion and exclusion criteria were included in this study. After taking detailed history and clinical examination, laboratory investigations including complete blood count (CBC), serum iron, serum, ferritin, serum transferrin saturation, TIBC, CHr and bone marrow aspiration with iron stain were done in all patients. Results: In the study group of 60 patients, 10(16.66%) patients had mild anaemia, 17(28.33%) had moderate anaemia and 33(55%) had severe anaemia. Mean haemoglobin of the patients was 6.86g/dL and SD was 1.95g/dL. Nineteen (31.66% patients) had TIBC in the range of 351-400 µg/dl. Mean ± SD of serum TIBC was 333.91 ± 67.26 µg/dL. Thirty-nine patients (65%) had transferrin saturation in the range of 0.1-10%. The Mean ± SD of the study group was 13.68 ± 3.22%. Fifty (83.33%) patients had serum ferritin in the range of 0-100 µg/dL. Twenty-three patients (38.33%) had CHr concentration between 15.1-20pg followed by 19(31.66%) between 20.1-25pg and 18(30%) between 25.1-30pg. The Mean ± SD of this study was 22.14pg ± 3.92. Conclusion: Reticulocyte haemoglobin content is a potential biomarker that can be used to differentiate iron deficiency anaemia from other causes of anaemia