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

Background: Reticulocyte hemoglobin content (CHr) is helpful for early diagnosis of iron deficiency anemia (IDA). However, its use is limited in thalassemia carriers. Objectives: To determine the accuracy of CHr and reticulocyte count as a test for iron deficiency anemia in Thai patients with microcytic red cells given the high prevalence of thalassemia carriers in Thailand. Methods: Thai patients with adult microcytic anemia (mean corpuscular volume ?80 fL) were prospectively enrolled. We conducted an automated complete blood count, reticulocyte count (with CHr), ferritin, and hemoglobin analysis. IDA was defined by a ferritin reference level Results: We included 168 patients (53 with IDA, 50 with anemia of inflammation (AI), 49 with thalassemia traits, and 16 with thalassemia diseases) and 99 healthy controls. The CHr in patients with IDA and thalassemia disease were significantly less than those in patients with AI and thalassemia trait (P Conclusions: CHr combined with additional information about reticulocyte count and MCHC is useful for diagnosis of IDA in Thais. Keywords: Diagnostic test, iron deficiency, microcytic anemia, reticulocyte hemoglobin content