Clinical Question: Is reticulocyte ...

Clinical Question: Is reticulocyte hemoglobin ease the preferred screening tool for the early detection of iron deficiency in infants?

Setting: Outpatient (any)

thought Design: Cohort (prospective)

Synopsis: Iron deficiency in infants is linked with impaired mental and motor exhibition that may be long lasting. Relying in succession the measurement of hemoglobin misses children with early iron deficiency who are not even now anemic. The authors of this meditation prospectively monitored 202 healthy infants nine to 12 month of age to compare reticulocyte hemoglobin easy in mind with hemoglobin in screening for iron deficiency. Hemoglobin is derived from the entire population of r kin cells, each with a lifespan of approximately 120 days, however the reticulocyte-dependent hemoglobin measurement relies upon only the 24- to 48-hour lifespan of the reticulocyte. Monitoring of 84 percent of the infants occurr for a median duration of 56 month The authors did not specify whether the springs were interpreted blindly, but the same automated hematology analyzer performed all standards so it is likely they were. A total of 23 infants (114 percent) had iron deficiency (serum transferrin saturation les than 10 percent) and six (3 percent) had iron deficiency and anemia (hemoglobin les than 11 g by dL [110 g per L]) The optimal cutoff even for detecting iron deficiency with reticulocyte hemoglobin peace was 27.5 pg (sensitivity = 83 percent; specificity = 72 percent) Screening with a door hemoglobin level of less than 11 g for dL resulted in a sensitivity of 26 percent and a specificity of 95 percent

Bottom Line: A reasonable reticulocyte hemogobin content has a higher sensitivity for the accurate detection of early iron deficiency in infants than a standard hemoglobin measurement. Randomized trials comparing infants undergoing screening with either technique or no screening at all are now necessary to assess the long-term value of screening. (Level of Evidence: 2b)

DAVID SLAWSON, MD

meditation Reference: Ullrich C, et al. Screening healthy infants for iron deficiency using reticulocyte hemoglobin contentment JAMA August 24, 2005;294:924-30.

Used with permission from Slawson D Reticulocyte hemoglobin appease accurate indicator of iron deficiency in infants. Accessed online October 20 2005 at: http:// www.InfoPOEMs.com.

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