Reticulocyte hemoglobin content changes after treatment of anemia of prematurity

Abstract

Background Iron deficiency during infancy is associated with poor neurological development, but iron overload causes severe complications. Appropriate iron supplementation is therefore vital. Reticulocyte hemoglobin content (RET‐He) provides a real‐time assessment of iron status and chracterezes hemoglobin synthesis in preterm infants. However, the existing literature lacks detailed reports assessing chronological changes in RET‐He. The aim of this study was to assess the chronological changes in RET‐He during oral iron dietary supplementation, and concomitant therapy with recombinant human erythropoietin (rHuEPO) in preterm very low birthweight infants. Methods Very low birthweight infants, admitted to our neonatal intensive care unit were analyzed retrospectively. Hemoglobin (Hb), reticulocyte percentage (Ret), mean corpuscular volume, RET‐He, serum iron (Fe), and serum ferritin were recorded. Data at birth (T0), the initial day of rHuEPO therapy (T1), the initial day of oral iron supplementation (T2), 1–2 weeks (T3), 3–4 weeks (T4), 5–6 weeks (T5), and 7–8 weeks (T6) from the initial day of oral iron supplementation were extracted, and their changes over time were examined. Results Reticulocyte hemoglobin content was highest at birth and declined rapidly thereafter, especially after starting rHuEPO therapy. There was no upward trend in RET‐He after the initiation of oral iron supplementation, with a slower increase during 5–6 weeks after the initiation of iron therapy. Conclusions During the treatment of anemia of prematurity, low RET‐He levels may be prolonged. Anemia of prematurity should therefore be assessed and treated on a case‐by‐case basis, while considering the iron metabolic capacity of preterm infants.

Hemoglobina reticulocitaria en el diagnóstico precoz de la anemia por deficiencia de hierro

“…Por otro lado, debido a la vida útil de los glóbulos rojos (120 días), estos parámetros tienen un gran retraso en su respuesta (15). Por ello la Hemoglobina Reticulocitaria (CHr) proporciona una evaluación en tiempo real del estado del hierro y caracteriza la síntesis de la hemoglobina (17).…”

“…Por lo tanto, una medición de la CHr refleja el metabolismo real del hierro de la eritropoyesis y permite evaluar la calidad de las células (20). Los cambios en el estado de hierro de la eritropoyesis pueden así detectarse mucho antes que, determinando únicamente el contenido de hemoglobina de los eritrocitos maduros (17). De esta manera, es muy importante usarlo de forma rutinaria para el prediagnóstico de IDA, ya que el CHr es un mejor biomarcador que las pruebas tradicionales para determinar IDA (21).…”