Evaluation of red cell and reticulocyte parameters as indicative of iron deficiency in patients with anemia of chronic disease

Abstract

ObjectiveThe purpose of this study was to evaluate the effectiveness of mature red cell and reticulocyte parameters under three conditions: iron deficiency anemia, anemia of chronic disease, and anemia of chronic disease associated with absolute iron deficiency.MethodsPeripheral blood cells from 117 adult patients with anemia were classified according to iron status, and inflammatory activity, and the results of a hemoglobinopathy investigation as: iron deficiency anemia (n = 42), anemia of chronic disease (n = 28), anemia of chronic disease associated with iron deficiency anemia (n = 22), and heterozygous β thalassemia (n = 25). The percentage of microcytic red cells, hypochromic red cells, and levels of hemoglobin content in both reticulocytes and mature red cells were determined. Receiver operating characteristic analysis was used to evaluate the accuracy of the parameters in differentiating between the different types of anemia.ResultsThere was no significant difference between the iron deficient group and anemia of chronic disease associated with absolute iron deficiency in respect to any parameter. The percentage of hypochromic red cells was the best parameter to discriminate anemia of chronic disease with and without absolute iron deficiency (area under curve = 0.785; 95% confidence interval: 0.661–0.909, with sensitivity of 72.7%, and specificity of 70.4%; cut-off value 1.8%). The formula microcytic red cells minus hypochromic red cells was very accurate in differentiating iron deficiency anemia and heterozygous β thalassemia (area under curve = 0.977; 95% confidence interval: 0.950–1.005; with sensitivity of 96.2%, and specificity of 92.7%; cut-off value 13.8).ConclusionThe indices related to red cells and reticulocytes have a moderate performance in identifying absolute iron deficiency in patients with anemia of chronic disease.

Preparation and Characterization of a Novel Polysaccharide-Iron(III) Complex in Auricularia auricula Potentially Used as an Iron Supplement

“…Polysaccharide-iron complexes have been the most studied among all of the iron(III) complexes because they have high stability and water solubility, and more important, reduced side effects [14, 15]. Polysaccharide-iron complexes have also been used as iron supplements for treatment of iron deficiency anemia because of their relatively high bioavailability and significant reduction of side effects, e.g., gastrointestinal discomfort and oxidative stress induced by a high concentration of iron(III) absorption, in comparison with those of traditional oral iron supplements [16].…”

Utilizing Extended Red Blood Cell Parameters to Distinguish Iron-Deficient Erythropoiesis - Related Disorders in Malaysian Female Population

“…The utility of eRBC parameters is not only limited to distinguishing iron-deficiency related disorders, as shown in a similar study by Torino, et al [25] which reported %Hypo-He and %MicroR as a parameter of interest in distinguishing anemia of chronic disease based on red cell sizes into macrocytic, normocytic, and microcytic anemia, the diagnostic utility of microcytes within this study strongly indicate that most of the iron deficiency anemia considered within female subjects are microcytic anemia, which is often associated with iron deficiency [24], which further explained our findings. This study also establishes other effective red cell parameters to distinguish LID from IDA or vice versa as shown in Table 2.…”

Iron status and choice of iron therapy during pregnancy: advantages and disadvantages

“…These data are helpful in the diagnosis of IDA, β-thalassemia (β-thal) carriers, and anaemia of chronic disease (ACD). 37 Normally, the percentage of HRBC is < 2.5%, and in iron deficiency a value of >5-10% is seen. 14 The transferrin receptor (TfR) is a 760-amino-acid glycoprotein.…”