ISSN 2997-1036
International Journal of Hematology | Vol. 9, No. 2, February 2018 | pp. 9–16
DOI: 10.46882/2018/IJH/000098
Original Article
Title: Evaluation of automated reticulocyte cellular volume and mean reticulocyte hemoglobin parameters in separating iron deficiency from alpha-thalassemia traits
Names of Authors: Q. S. Abubakar¹, U. T. Maina²
Authors’ Affiliations: ¹Department of Haematology, National Hospital, Abuja, Nigeria; ²Department of Pathology, Bayero University, Kano, Nigeria
Abstract: Microcytic hypochromic anemias require fast, automated differentiation protocols to prevent inappropriate therapeutic decisions. This prospective diagnostic study evaluated the performance of automated reticulocyte cell parameters, specifically mean reticulocyte volume (MRV) and mean reticulocyte hemoglobin content (CHr), in separating absolute iron deficiency anemia from alpha-thalassemia trait variants. Evaluations were conducted on 125 adult patients presenting with microcytosis (MCV < 75 fl), and diagnoses were validated via serum ferritin and molecular multiplex polymerase chain reaction assays. Absolute iron deficiency was confirmed in 75 cases, while 50 carried the single-gene alpha-deletion (-alpha³.⁷/alpha alpha). The mean reticulocyte volume was significantly lower in alpha-thalassemia trait carriers compared to iron deficiency cohorts (54.2 ± 3.8 fl versus 68.5 ± 4.2 fl, P < 0.001). Conversely, the mean reticulocyte hemoglobin content was severely reduced in iron deficiency. Receiver operating characteristic analysis established an MRV threshold below 58.0 fl as optimal for predicting alpha-thalassemia gene deletions, achieving a sensitivity of 88.0% and a specificity of 85.3%. Utilizing automated reticulocyte volume parameters provides a highly efficient screening asset for differentiating inherited hemoglobin traits from nutritional deficiencies.
Keywords: Reticulocyte volume, reticulocyte hemoglobin, iron deficiency anemia, alpha-thalassemia trait, cell counter indices
Manuscript Timeline: Received: November 15, 2017; Revised: December 22, 2017; Accepted: January 11, 2018; Published: February 14, 2018