A prospective evaluation of the reticulocyte haemoglobin content (CHr) at the Charlotte Maxeke Johannesburg Academic Hospital

Introduction: The diagnosis of iron deficiency anaemia (IDA) in hospitalised patients with chronic infection and inflammation presents a challenge. Recently laboratory tests such as the reticulocyte haemoglobin content (CHr), which are independent of infection and inflammation, have become available for routine diagnostic use. Methods: A study was conducted at the Charlotte Maxeke Johannesburg Academic Hospital in order to compare the accuracy of the CHr with that of standard haematological tests for the diagnosis of IDA. The study population included 74 adult and paediatric inpatients that were anaemic. There were 20 patients with IDA, 44 patients with anaemia of chronic disease (ACD) and 10 patients with IDA/ACD as defined according to bone marrow iron stores, supporting iron studies and markers of inflammation. Results: CHr, mean cell volume, mean cell haemoglobin (MCH) levels were significantly lower in the IDA and IDA/ACD groups as compared to the ACD group (p 28 pg reliably distinguished IDA and ACD with a sensitivity of 77.78% and a specificity of 79.55%. On ROC analysis, however, the diagnostic performance of the CHr (0.84, 95% CI 0.74-0.94) was not superior to the MCH (0.84, 95% CI 0.73-0.95). Conclusion: The CHr is a simple, cost-effective, reliable test for the diagnosis of IDA in hospitalised patients. The CHr parameter, however, is not superior to standard haematological tests.