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Blood, 15 February 2002, Vol. 99, No. 4, pp. 1489-1491
BRIEF REPORT
Clinical utility of the reticulocyte hemoglobin content in the
diagnosis of iron deficiency
Alan E. Mast,
Morey A. Blinder,
Qing Lu,
Sherri Flax, and
Dennis J. Dietzen
From the Research and Pathology Services, Department of
Veterans Affairs, Memphis, TN; the Department of Pathology, University
of Tennessee, Memphis; and the Department of Pathology and Immunology,
Washington University, St Louis, MO.
Determination of the reticulocyte hemoglobin content (CHr)
provides an early measure of functional iron deficiency because reticulocytes are the earliest erythrocytes released into blood and
circulate for only 1 to 2 days. The CHr in 78 patients undergoing bone
marrow examination was measured to assess its clinical utility for the
diagnosis of iron deficiency. Twenty-eight patients were iron
deficient, based on the lack of stainable iron in the aspirate. The
diagnostic power of CHr is limited in patients with high mean cellular
volume (MCV) or red cell disorders such as thalassemia. However, when
patients with MCV more than 100 fL are excluded, receiver operator
curve analysis of CHr, ferritin, transferrin saturation, and MCV
demonstrates that CHr has the highest overall sensitivity and
specificity of these peripheral blood tests for predicting the absence
of bone marrow iron stores.

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