Reticulocyte Parameters

Abstract

The aim of the present study was to determine the effects of exclusive oral iron supplementation (iron sulphate 2 mg/kg/die) in asymptomatic children with severe iron-deficiency anemia [median hemoglobin (Hb) level before treatment 6.3 g/dL; range 4.5 to 7 g/dL] and to investigate the accuracy of Hb, reticulocyte hemoglobin content (CHr), and absolute reticulocyte count (ARC) as markers for monitoring early response to treatment. The increase in ARC and CHr was statistically significant at day +3. There was a significant association between suitable logarithmic functions of the percentage increase in CHr and ARC at day +3 and the fraction of required Hb increase compared with baseline to reach the mean reference value for age and sex at day +14. If these results are confirmed in a larger population, ARC and CHr could be considered affordable and widely available markers to detect early responders to oral iron therapy, and to switch unresponsive children to parenteral iron supplementation or transfusion.

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

“…Similar conclusion regarding response to exclusive oral iron therapy in a small cohort of children with severe iron deficiency anemia had been previously reported by our group [ 9 ]. Main outcome of our preliminary study [ 9 ] was to evaluate if oral iron supplementation should be proposed as first-line treatment in a small cohort of clinically asymptomatic patients with severe iron deficiency anemia.…”

“…Similar conclusion regarding response to exclusive oral iron therapy in a small cohort of children with severe iron deficiency anemia had been previously reported by our group [ 9 ]. Main outcome of our preliminary study [ 9 ] was to evaluate if oral iron supplementation should be proposed as first-line treatment in a small cohort of clinically asymptomatic patients with severe iron deficiency anemia. These patients, due to their Hb levels (median 6.3 g/dL, range 4.5–7), needed a tight follow-up; for that reason, the kinetic of response was assessed within 48 hours from the onset of iron administration (T1) and our data demonstrated the utility of ARC and CHr as accurate markers for the early detection of patients not responding to oral iron to be quickly switched to other therapies (parenteral iron supplementation or transfusion).…”

“…Patients with diagnosis of celiac disease, positivity of fecal occult blood test, or positivity of Helicobacter pylori fecal antigen test were excluded. Patients from our preliminary report were not included in the present study [ 9 ].…”

“…Thus, in our Pediatric Hematology Unit, oral iron treatment is the first-line therapy for all children with IDA with anamnestic suspicion of inadequate iron intake, independently of base Hb level. Recently, we have identified absolute reticulocyte count (ARC) and CHr as accurate and precocious markers in order to early detect early responders to exclusive oral iron therapy in a small cohort of pediatric patients with severe iron deficiency anemia (IDA) [ 9 ]. These preliminary results in children with very low base Hb levels (median Hb level before treatment 6.3 g/dL; range 4.5–7.0) prompted us to investigate the efficacy of reticulocyte parameters in monitoring the response to oral iron supplementation in a larger cohort of pediatric patients.…”

High prevalence of iron deficiency anemia in infants attending a well-baby clinic in NorthWestern Saudi Arabia

“… 4 Among the new hematological parameters recently developed to precisely diagnose IDA, CHr has recently gained ample attention in the pediatric clinical settings since it is found to be the strongest predictor of ID and IDA, 2 , 5 , 6 as well as it could be considered an affordable and widely available marker to detect early responders to oral iron therapy and to switch unresponsive children to parenteral iron supplementation or transfusion. 7 Actually, the utility of CHr in the identification of Saudi children with IDA has been evaluated and showed that a CHr cut-off level of 26 pg is considered to be a reasonable indicator of anemic states. Moreover, CHr together with a complete blood count might provide an alternative to the traditional hematologic or biochemical panel for the diagnosis of ID and IDA in young children and it is cost-effective.…”