Evaluating RET-Hb vs Hb in Predicting Early Response in Oral Iron Therapy: A Prospective Interventional Study
Introduction: Children are more vulnerable to anaemia due to their rapid growth, which requires an expanding erythroid mass and a high tissue iron demand. Anaemia can negatively impact psychomotor and cognitive development and can lead to a decline in immunity. Reticulocytes are precursors to erythr...
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| Published in: | Journal of clinical and diagnostic research Vol. 18; no. 11; pp. 01 - 05 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
01-11-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Introduction: Children are more vulnerable to anaemia due to their rapid growth, which requires an expanding erythroid mass and a high tissue iron demand. Anaemia can negatively impact psychomotor and cognitive development and can lead to a decline in immunity. Reticulocytes are precursors to erythrocytes and make up about 1% (ranging from 0.5% to 2.5%) of circulating erythrocytes. The reticulocyte content serves as a measurement of haemoglobin within the reticulocyte and correlates directly with the functional availability of iron in the bone marrow. Consequently, it is considered one of the strongest predictors of Iron Deficiency (ID). The Reticulocyte Haemoglobin Content (RET-Hb) level is useful for diagnosing anaemia before it clinically manifests in a patient. Aim: To assess the effectiveness of RET-Hb content as a predictor for early response to oral iron therapy in comparison to haemoglobin levels. Materials and Methods: This prospective interventional study was conducted in the Department of Paediatrics at a tertiary care Hospital in Thrissur, Central Kerala, India, over a period of 18 months, from December 2019 to June 2021. A total of 44 samples were included in the study, and socio-demographic details were collected using a semistructured proforma from patients with haemoglobin levels below the mean reference value. Baseline haemogram parameters {Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW), Haemtocrit (HCT)}, reticulocyte indices, and ferritin levels were measured before administering oral iron therapy (T0). These parameters were reassessed after seven days (T1) and 30 days (T2) following the initiation of therapy. The Chi-square test was used to assess the association between various factors, and Pearson’s correlation coefficient was utilised to find the correlation. Results: The mean age of the participants was 3.46±2.2 years, with 24 males and 20 females included in the study. The mean RET-Hb was 21.15±1.71 pg before the initiation of treatment, which significantly increased to 23.37±1.95 pg and 25.77±1.56 pg at days 7 and 30, respectively. The haemoglobin level increased from 8.37±1.25 g/L to 8.55±1.19 g/L and 9.72±0.98 g/L at T1 and T2, respectively, which was statistically significant. The Absolute Reticulocyte Count (RET#) also showed a significant early increase after initiating treatment. Conclusion: These findings indicate that RET-Hb and RET# are reliable early predictors of response to iron therapy, alongside haemoglobin levels, and can be used as effective alternatives. |
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| ISSN: | 2249-782X 0973-709X |
| DOI: | 10.7860/JCDR/2024/70908.20223 |