DIAGNOSTIC ACCURACY OF RETICULOCYTE HAEMOGLOBIN EQUIVALENT (RETHE) IN DETECTING IRON DEFICIENCY ANAEMIA KEEPING SERUM FERRITIN AS GOLD STANDARD
Keywords:Diagnostic Accuracy, Iron deficiency anemia, Reticulocyte Haemoglobin Equivalent (Ret-He), Serum ferritin
Objective: To determine the diagnostic accuracy of Ret-He in detecting IDA, keep ingserum ferritin as goldstandard
Study Design: Cross sectional study.
Place and Duration of Study: Department of Haematology, AFIP Rawalpindi, from Jan to Jul 2017.
Methodology: Study involved 165 female patients who presented with anemia (hemoglobin <11g/dl). Ret-He was determined having a level of <27.8 pg/L as diagnostic of IDA. Diagnosis of IDA was confirmed on serum ferritin level <11 ng/ml taking it as gold standard. Accordingly, diagnostic accuracy of Ret-He was determined considering low serum ferritin level as gold standard.
Results: The mean age of the patients was 27.52 ± 13.57 years. Mean hemoglobin level was 9.17 ± 1.59 g/dl while mean serum ferritin level was 15.20 ± 12.89 ng/ml. Ret-He ranged from 11.0 pg/L to 39.4 pg/L with a mean of 23.34 ± 8.21 pg/L. IDA on the basis of serum ferritin level was diagnosed in 75 (45.5%) patients while Ret-He labeled IDA in 85 (51.5%) patients. When cross-tabulated, there were 70 TP, 15 FP, 5 FN and 75 TN cases which yielded 93.33% sensitivity, 83.33% specificity, 87.88% accuracy, 82.35% PPV and 93.75% NPV for Ret-He in diagnosing IDA keeping serum ferritin as gold standard. Thus the optimal cut-off value of Ret-He was found to be <27.6 pg/L which gave 93.33% sensitivity and 83.33% specificity in detecting IDA keeping serum ferritin as gold standard.
Conclusion: Ret-He was found as fast and reliable technique to diagnose IDA in female population. However, further studies are required for confirmation of its efficacy.