Absolute Reticulocyte Count and Reticulocyte Hemoglobin Content as Predictors of Early Response to Exclusive Oral Iron in Children with Iron Deficiency Anemia

Parodi, Emilia; Giraudo, Marı́a Teresa; Ricceri, Fulvio; Aurucci, Maria Luigia; Mazzone, R; Ramenghi, Ugo

doi:10.1155/2016/7345835

Cited by 24 publications

(24 citation statements)

References 10 publications

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“…20,32,33 On the contrary, the absolute reticulocyte count has been found to increase significantly within 7 days from the beginning of oral iron supplementation (2 mg/kg/day) in iron-deficient anemic children. 34 Our result confirms previous recommendations that all forms of iron supplementation within the previous 7 days must be recorded on the doping control form. 20 Such information should also be made available for experts upon evaluation of atypical passport findings according to WADA's requirements for the management of the ABP.…”

Section: Intra-individual Variationsupporting

confidence: 90%

Fluctuations in hematological athlete biological passport biomarkers in relation to the menstrual cycle

Mullen

Bækken²,

Bergström

et al. 2020

Drug Testing and Analysis

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The interpretation of athlete biological passport (ABP) is strengthened by understanding the natural fluctuations in its biological parameters. Here we have assessed the influence of the menstrual cycle on the hematological module of the ABP. Seventeen women with regular menses were included. Blood samples were collected once a week for two consecutive cycles and analyzed for hematological parameters. Menstrual phases were hormonally determined. The intra‐individual variation in the hematological parameters was similar between the two cycles. Reticulocyte percentage was significantly lower in the follicle phase (median 0.95%) than in the ovulatory (median 1.10%) and luteal phases (median 1.16%), P = 0.006, whereas no differences were found in hemoglobin concentration, hematocrit, red blood cell count, or red blood cell indices. When the values were entered into the ABP model, findings outside the program‐calculated individual thresholds were identified in two participants. One woman showed an atypical low OFF‐score in the last sample collected, mainly because of increased reticulocyte percentage. This was likely a response to treated insufficient iron stores. One woman displayed an atypical hemoglobin value at the lower limit 2 weeks after ovulation, which was likely due to fluctuations in plasma volume. In conclusion, the ABP parameters in general are stable throughout the menstrual cycle. Significant differences between the menstrual phases were found in reticulocytes; however, the variation was not related to findings outside the individual thresholds, except in one individual. Moreover, our results highlight the importance of having information about iron supplementation available when evaluating hematological passports.

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Section: Intra-individual Variationsupporting

confidence: 90%

Fluctuations in hematological athlete biological passport biomarkers in relation to the menstrual cycle

Mullen

Bækken²,

Bergström

et al. 2020

Drug Testing and Analysis

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“…Unfortunately, a similar association between a serum iron panel index and brain iron deficiency and dysfunction beyond the newborn period has yet to be determined. Reticulocyte Hgb content is the strongest predictor of iron deficiency and response to iron supplementation in children [ 47 , 48 ]. Unpublished studies in neonatal rats from our lab suggest that reticulocyte Hgb is a sensitive peripheral biomarker of impending brain iron deficiency.…”

Section: Screening and Treatment Strategiesmentioning

confidence: 99%

Approaches for Reducing the Risk of Early-Life Iron Deficiency-Induced Brain Dysfunction in Children

2018

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Iron deficiency is the most common micronutrient deficiency in the world. Women of reproductive age and young children are particularly vulnerable. Iron deficiency in late prenatal and early postnatal periods can lead to long-term neurobehavioral deficits, despite iron treatment. This may occur because screening and treatment of iron deficiency in children is currently focused on detection of anemia and not neurodevelopment. Anemia is the end-stage state of iron deficiency. The brain becomes iron deficient before the onset of anemia due to prioritization of the available iron to the red blood cells (RBCs) over other organs. Brain iron deficiency, independent of anemia, is responsible for the adverse neurological effects. Early diagnosis and treatment of impending brain dysfunction in the pre-anemic stage is necessary to prevent neurological deficits. The currently available hematological indices are not sensitive biomarkers of brain iron deficiency and dysfunction. Studies in non-human primate models suggest that serum proteomic and metabolomic analyses may be superior for this purpose. Maternal iron supplementation, delayed clamping or milking of the umbilical cord, and early iron supplementation improve the iron status of at-risk infants. Whether these strategies prevent iron deficiency-induced brain dysfunction has yet to be determined. The potential for oxidant stress, altered gastrointestinal microbiome and other adverse effects associated with iron supplementation cautions against indiscriminate iron supplementation of children in malaria-endemic regions and iron-sufficient populations.

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“…Previously, it was reported that Ret-He content is an early and accurate predictor of hematological response to oral iron therapy in children. 13 Few recent studies have also evaluated Ret-He content to assess latent iron deficiency and microcytic red blood cells in adult populations. 14,15 Chaipokam et al concluded that Ret-He content combined with reticulocyte and blood count is useful in evaluating microcytic red blood cells in Thai patients while Tiwari et al observed that Ret-He may be used in routine screening of latent iron deficiency in blood donors.…”

Section: Discussionmentioning

confidence: 99%

Role of Reticulocyte Parameters in Anemia of First Trimester Pregnancy: A Single Center Observational Study

et al. 2020

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Introduction The diagnosis of anemia in pregnancy should be early to prevent complications to mother and baby. It should be simple and safe, and therefore feasibility of reticulocyte parameters may prove beneficial in this regard. Newer reticulocyte parameters have not been studied extensively especially in pregnancy. The present study was conducted to evaluate reticulocyte hemoglobin content (Ret-He), immature reticulocyte fraction, and reticulocyte count and to compare them with serum ferritin, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in assessment anemia in pregnancy. Material and Methods Prospective study included first trimester pregnant females where hemoglobin, MCV, and MCH were categorized and statistically analyzed with serum ferritin and reticulocyte parameters. Results The study included 155 first trimester pregnant females showing statistical difference in Ret-He between all categories of hemoglobin and MCV (p < 0.05). ROC curve analysis using MCV < 83 fl and MCH <27 pg showed that area under curve for Ret-He at cutoff of 27.8 ng/mL was 0.93 (95% confidence interval 0.90–0.98, sensitivity 93%, specificity 83%). The cutoff of 27.2 ng/mL Ret-He for the diagnosis of iron deficiency anemia has specificity of 86%, sensitivity 71%, positive predictive value 0.39, and likelihood ratio of 5.1. Conclusion Ret-He is a feasible and easily available parameter which may be helpful in differentiating between microcytic hypochromic and normocytic normochromic anemia along with frank and borderline anemia in first trimester pregnant females. This in turn is essential to initiate an early therapy so as to prevent the maternal and fetal complications.

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Absolute Reticulocyte Count and Reticulocyte Hemoglobin Content as Predictors of Early Response to Exclusive Oral Iron in Children with Iron Deficiency Anemia

Cited by 24 publications

References 10 publications

Fluctuations in hematological athlete biological passport biomarkers in relation to the menstrual cycle

Fluctuations in hematological athlete biological passport biomarkers in relation to the menstrual cycle

Approaches for Reducing the Risk of Early-Life Iron Deficiency-Induced Brain Dysfunction in Children

Role of Reticulocyte Parameters in Anemia of First Trimester Pregnancy: A Single Center Observational Study

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