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Diagnostic accuracy of reticulocyte hemoglobin content in Thai patients with microcytic red cells as a test for iron deficiency anemia

Jindaratn Chaipokam
Jindaratn Chaipokam
, 
Thanyaphong Na Nakorn
Thanyaphong Na Nakorn
 oraz 
Rojnuckarin Ponlapat
Rojnuckarin Ponlapat
   | 31 mar 2017
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Article Category: Original article
Data publikacji: 31 mar 2017
Zakres stron: s31 - s37
DOI: https://doi.org/10.5372/1905-7415.1000.519
Słowa kluczowe
© 2016 Jindaratn Chaipokam, Thanyaphong Na Nakorn, Ponlapat Rojnuckarin
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

The correlation between the reticulocyte hemoglobin content (CHr) values and hemoglobin levels in patients with microcytic red blood cells (r = 0.77, P < 0.001)
The correlation between the reticulocyte hemoglobin content (CHr) values and hemoglobin levels in patients with microcytic red blood cells (r = 0.77, P < 0.001)

Figure 2

Receiver operating characteristic (ROC) analysis, the areas under the curve (AUC) and the performance of reticulocyte hemoglobin content (CHr) and mean corpuscular hemoglobin concentration (MCHC) in diagnosis of iron deficiency anemia (IDA). A: For the entire study population, the CHr cutoff of 24.6 pg showed 73.6% sensitivity, 74.8% specificity, 42.4% positive predictive value (PPV), 92.0% negative predictive value (NPV), and 74.9% accuracy. B: When the thalassemia group was excluded, the CHr cutoff of 27.2 pg showed 84.9% sensitivity, 81.2% specificity, 60.8% PPV, 93.4% NPV, and 81.7% accuracy. C: When patients with thalassemia disease was excluded, the CHr cutoff of 27.0 pg showed 84.9% sensitivity, 77.8% specificity, 52.3% PPV, 94.7% NPV, and 79.4% accuracy. D: ROC curve of the MCHC for differentiation of IDA and thalassemia trait: the MCHC cutoff of 31.6 g/dL showed 81.1% sensitivity, 83.7% specificity, 81.5% PPV, 81.3% NPV, and 81.4% accuracy.
Receiver operating characteristic (ROC) analysis, the areas under the curve (AUC) and the performance of reticulocyte hemoglobin content (CHr) and mean corpuscular hemoglobin concentration (MCHC) in diagnosis of iron deficiency anemia (IDA). A: For the entire study population, the CHr cutoff of 24.6 pg showed 73.6% sensitivity, 74.8% specificity, 42.4% positive predictive value (PPV), 92.0% negative predictive value (NPV), and 74.9% accuracy. B: When the thalassemia group was excluded, the CHr cutoff of 27.2 pg showed 84.9% sensitivity, 81.2% specificity, 60.8% PPV, 93.4% NPV, and 81.7% accuracy. C: When patients with thalassemia disease was excluded, the CHr cutoff of 27.0 pg showed 84.9% sensitivity, 77.8% specificity, 52.3% PPV, 94.7% NPV, and 79.4% accuracy. D: ROC curve of the MCHC for differentiation of IDA and thalassemia trait: the MCHC cutoff of 31.6 g/dL showed 81.1% sensitivity, 83.7% specificity, 81.5% PPV, 81.3% NPV, and 81.4% accuracy.

Figure 3

Algorithm proposed for diagnosis of microcytic anemia using complete blood and reticulocyte counts
Algorithm proposed for diagnosis of microcytic anemia using complete blood and reticulocyte counts

The means (standard deviations) for age, sex, and red cell indices of the 3 groups of microcytic patients and healthy controls

DiagnosisControlAIThalassemiaIDA
TraitDisease
N9950491653
Age (years)37.3 (10.8)a.02754.8 (20.6)b.01445.9 (18.0)c<0.9935.8 (14.7)d.3944.8 (16.8)d.05
Sex (%): male/female18.2/81.8a.35028.0/72.0b.05130.6/69.4c.1018.8/81.2d.9654.7/45.3d.22
MCV (fL)88.8 (3.5)a<.0072.8 (5.4)b.00269.0 (8.4)c<0.9964.1 (8.1)d.5468.5 (9.2)d.03
Hb (g/dL)13.5 (1.0)a<.0019.4 (1.6)b.1110.7 (2.1)c<.0018.8 (1.0)d>0.998.5 (2.7)d.29
MCH (pg)29.3 (1.4)a<00123.3 (2.0)b.00622.5 (2.8)c.01918.9 (2.5)d.5220.4 (3.7)d<.001
MCHC (g/dL)33.0 (0.8)a<00132.2 (2.2)b>.9932.7 (1.8)c<00129.6 (2.6)d>0.9929.3 (3.0)d<.001
RDW (%)13.5 (0.6)a<.00117.9 (3.2)b>.9616.7 (2.8)c<.00124.3 (4.9)d.0620.1 (4.3)d.03
CHr (pg)33.1 (2.4)a<00126.6 (3.9)b.00925.2 (4.1)c<.00120.5 (3.5)d>0.9921.2 (5.5)d<.001
Reticulocyte (x109/L)46.2 (14.7)a>0.9952.1 (31.3)b.5863.5 (50.1)c.34146.1 (101.2)d.01446.7 (26.5)d.93
Ferritin (μg/L)Not done1,766.0 (3,772.0)b.15386.5 (459.8)c<.001974.6 (1,212.3)d.0609.5 (8.4)d.011

The correlation of age and other variables (95% CI)

AgeParameters
MCVHbMCHMCHCRDWCHr
r–0.12–0.25–0.13<0.0010.07–0.07
P0.04<0.0010.040.990.250.27
eISSN:
1875-855X
Język:
Angielski
Częstotliwość wydawania:
6 razy w roku
Dziedziny czasopisma:
Medicine, Assistive Professions, Nursing, Basic Medical Science, other, Clinical Medicine
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