Age, beta thalassaemia trait, and iron-deficient anaemia significantly affect reticulocyte indices in pre-school children

Eur J Pediatr. 2010 Sep;169(9):1097-104. doi: 10.1007/s00431-010-1186-7. Epub 2010 Mar 25.

Abstract

Background: Reticulocyte indices are easy to obtain, low cost parameters and have gained interest in the field of diagnosing anaemias of childhood.

Methods: We assessed distribution, age and gender variation, relation to indices of iron metabolism and diagnostic performance of reticulocyte haemoglobin content (CHr), percentage of microcytic reticulocytes (micro_r), percentage of hypochromic reticulocytes (hypo_r), and percentage of reticulocytes with low CHr (low_CHr) in 386 pre-school children classified in four groups: healthy, iron deficiency (ID), iron deficiency anaemia (IDA), and beta-thalassaemia carriers (beta-thal).

Results: Age had a positive effect in CHr (Spearman's rho = 0.21) and a negative effect in hypo_r (Spearman's rho = -0.2) in healthy children. CHr and low_CHr were related to ferritin in the IDA group (Spearman's rho 0.55 and -0.53, respectively). In the beta-thal group, HbA(2) is strongly related to all reticulocyte indices. micro_r and CHr performed best in discriminating between IDA and beta-thal heterozygosity (ROC analysis, area under the curve (AUC): 0.76 and 0.74, respectively). CHr achieved the best AUC (0.58) in identifying ID among children without anaemia.

Conclusion: Age, IDA and beta-thal significantly affect reticulocyte indices. CHr and micro_r may have a role as screening tools in discriminating between IDA and beta-thal heterozygosity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Age Factors
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / diagnosis*
  • Anemia, Iron-Deficiency / epidemiology
  • Child, Preschool
  • Diagnosis, Differential
  • Erythrocyte Indices*
  • Female
  • Greece / epidemiology
  • Heterozygote
  • Humans
  • Infant
  • Iron / blood
  • Iron Deficiencies*
  • Male
  • ROC Curve
  • Reticulocyte Count / methods
  • Reticulocytes / cytology
  • Reticulocytes / metabolism*
  • Sex Distribution
  • Sex Factors
  • beta-Thalassemia / blood
  • beta-Thalassemia / diagnosis*
  • beta-Thalassemia / epidemiology

Substances

  • Iron