evaluation of red cell indices and reticulocyte maturity indices including reticulocyte haemoglobin concentration in iron deficiency anaemia in adult female population

BACKGROUND Prevalence of iron deficiency anaemia is higher in both developed, underdeveloped countries and in developing countries particularly in toddlers, adolescent girls and women of childbearing age. Diagnosis of iron deficiency is made by biochemical investigations along with the routine haemogram. Automated analysers in the recent years provide many reticulocyte parameters like Low Fluorescence Ratio (LFR), Medium Fluorescence Ratio (MFR) and High Fluorescence Ratio (HFR), Reticulocyte Haemoglobin Concentration-haemoglobin (Ret-He), which not only aid in the diagnosis of Iron Deficiency Anaemia (IDA) without the necessity of biochemical investigations, but also help in the follow up of these patients for bone marrow response accurately. The aim of the present study is to evaluate the effectiveness of these parameters in the diagnosis of iron deficiency anaemia in the female population in reproductive age group. MATERIALS AND METHODS The present study included peripheral blood samples from fifty eight women aged between 18-45 years from routine workload including 20 normal (Hb >12.0 g/dL with normal serum ferritin and serum iron levels) and 38 iron deficiency anaemia samples (Hb <12.0 g/dL and with low serum ferritin and serum iron levels). RESULTS There was significant differences in the means between the subjects from the control group and IDA group in red cell distribution width, RDW CV (%) (13.26±1.07 vs. 18.22±3.34 p-value <0.00001) and immature reticulocyte fraction (%) (9.87±5.68 vs. 17.89±9.00 p-value=.000646), reticulocyte haemoglobin concentration (pg) (33.34±2.92 vs. 22.0±4.13, p-value=<0.00001). Serum iron and serum ferritin showed statistically significant difference between two groups. CONCLUSIONS The reticulocyte parameters including Ret-He provide an important information in suspected cases of iron deficiency. Routine haemogram can thus be more helpful not only on morphological categorisation of anaemia, but also in knowing the underlying pathology.