Evidence map›Paper›PMID 42319743›Full record

ArticleIndian journal of pediatrics2026

Reticulocyte Hemoglobin Equivalent (Ret-He) as a Marker of Iron Deficiency Anemia in Acutely Ill Hospitalized Children.

Madhumati Suhas Otiv, Sarita Verma, Suman Garag, Mehmood Sayyad

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Article in Indian journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2 citing papers in PubMed.

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4 authors.

Madhumati Suhas OtivDepartment of Pediatrics, K.E.M Hospital and Research Center, Rasta Peth, Pune, 411011, India.
Sarita VermaDepartment of Pediatrics, K.E.M Hospital and Research Center, Rasta Peth, Pune, 411011, India. saritavermap@gmail.com.
Suman GaragDepartment of Pediatrics, K.E.M Hospital and Research Center, Rasta Peth, Pune, 411011, India.
Mehmood SayyadDepartment of Statistics, Abeda Inamdar Senior College of Arts Science and Commerce, Azam Campus, Camp, Pune, 411001, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate diagnostic utility of reticulocyte hemoglobin equivalent (Ret-He) in identifying iron deficiency anemia (IDA) in acutely ill hospitalized children in comparison to serum ferritin.

methodsAfter excluding chronic inflammatory and anemic conditions unrelated to iron deficiency (ID), patients were categorized as (1) IDA: low hemoglobin+ microcytosis+ red-cell-distribution-width (RDW) index >220, (2) Non-anemia-iron-deficiency (NAID): normal haemoglobin+ microcytosis+ RDW index >220 and (3) Normal-group: normal hemoglobin+ normocytosis. Diagnostic utility indices for IDA were calculated using low hemoglobin+ microcytosis + RDW index >220 as surrogate standard. Correlation coefficients and receiver-operating-characteristic (ROC) curve cut-offs for Ret-He and ferritin were calculated.

resultsAnemic (n = 180) and non-anemic (n = 66) acutely ill children, after exclusion criteria, were classified into IDA (n = 102), NAID (n = 14) and normal (n = 21). IDA group had significantly lower Ret-He levels (p <0.001). Ferritin levels showed no significant difference (p = 0.062). For IDA detection, Ret-He cut-off of 27.7 pg yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 87.2%, 80.9%, 95.7%, 56.7% and 86.2% whereas ferritin at cut-off of 147.0 ng/ml showed values of 58.8%, 66.7%, 89.5%, 25.0% and 60.2% respectively. For NAID detection, Ret-He cut-off of 29.1 pg showed sensitivity, specificity, PPV, NPV and accuracy of 71.4%, 57.1%, 52.6%, 75.0% and 62.9%, while ferritin at cut-off of 153 ng/ml showed values of 57.1%, 61.9%, 50.0%, 68.4%, and 60.0% respectively.

conclusionsRet-He demonstrated superior diagnostic utility compared to serum ferritin for IDA in acutely ill hospitalized children. Optimal cut-off for serum ferritin for IDA was significantly higher than WHO reference standard.

Indexed as

Anemia, Iron-DeficiencyHemoglobinsReticulocytesAcute DiseaseBiomarkersChildChild, HospitalizedChild, PreschoolErythrocyte IndicesFemaleFerritinsHumansInfantMaleROC CurveSensitivity and SpecificityBiomarkersFerritinsHemoglobinsAcutely ill childrenIron deficiency anemiaRDW indexReticulocyte hemoglobin

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.