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Is analysis of the reticulocyte haemoglobin equivalent a useful test for the diagnosis of iron deficiency anaemia in geriatric patients?
MedLine Citation:
PMID:  23063249     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: 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. METHODS: 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. RESULTS: 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 26pg had a sensitivity and specificity based on its optimal combination of 85% and 69% respectively. CONCLUSION: 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.
Authors:
Etienne Joosten; Pieter Lioen; Caroline Brusselmans; Christophe Indevuyst; Nancy Boeckx
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-9
Journal Detail:
Title:  European journal of internal medicine     Volume:  -     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Affiliation:
Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: etienne.joosten@uzleuven.be.
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