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pISSN 2950-9114 eISSN 2950-9122
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Original Article

Lab Med Qual Assur 2021; 43(3): 138-142

Published online September 30, 2021


Copyright © Korean Association of External Quality Assessment Service.

Clinical Utility of Reticulocyte Hemoglobin Equivalent in Diagnosing Iron Deficiency Anemia

Kyoung-Jin Park1 and Moon Jung Kim2

1Department of Laboratory Medicine & Genetics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon; 2Department of Laboratory Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea

Correspondence to:Kyoung-Jin Park
Department of Laboratory Medicine & Genetics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Paryong-ro, Masanhoewon-gu, Changwon 51353, Korea
Tel +82-55-233-6099
E-mail unmar.park@samsung.com

Received: May 13, 2021; Revised: June 30, 2021; Accepted: July 1, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Iron deficiency anemia (IDA) is one of the major global public health problems. Reticulocyte hemoglobin (Hb) equivalent (Ret-He) has been proposed as an early index for IDA. However, little information is available regarding the Ret-He in Korean patients with IDA. We aimed to investigate the clinical utility of Ret-He as a diagnostic index in Korean patients with IDA.
Methods: Laboratory data, including complete blood count and iron metabolism markers, were retrospectively reviewed. In total, 507 individuals were categorized into four groups based on Hb and iron index: iron deficiency (ID, n=21), IDA (n=254), non-IDA (n=150), and healthy control (HC, n=82). Receiver operating characteristic analysis was performed to evaluate the diagnostic power of Ret-He.
Results: The Ret-He levels from the ID and IDA groups were significantly lower than those from the non-IDA and HC groups (P-value <0.0001; median Ret-He: 32.2 pg for ID; 29.7 pg for IDA; 33.9 pg for non-IDA; and 34.5 pg for HC). The area under the curve of Ret-He was 0.851 at a cutoff of 32.3 pg, by which IDA was discriminated from HC (sensitivity of 72% and specificity of 90%).
Conclusions: This study suggests that Ret-He could be an alternative hematologic index for the diagnosis of IDA. Further prospective clinical studies are warranted to validate the clinical utility of Ret-He and to integrate it into the diagnostic algorithm for IDA.

Keywords: Reticulocyte hemoglobin equivalent, Ferritina, Iron-deficiency anemia, Anemia, Korean

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