Examinando por Autor "Huasasquiche Alfaro, Cynthia Nanette"

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Acceso abierto
Evaluation of reticulocytic hemoglobin as a biomarker of iron deficiency anemia in adults at the Hospital Nacional Dos de Mayo, Lima 2023
(Universidad Privada Norbert Wiener, 2024-06-30) Huasasquiche Alfaro, Cynthia Nanette; Huamán Cárdenas, Victor Raul
Iron deficiency is the most frequent cause of anemia, and reticulocyte hemoglobin is a new hematogram parameter of great value in diagnosing and managing iron-deficient erythropoiesis. Objective: To determine the usefulness of reticulocyte hemoglobin in diagnosing iron deficiency anemia in adult Peruvian patients. Methods: The clinical records of 120 adult patients who had undergone bone marrow aspiration at the National Hospital Dos de Mayo, according to selection criteria, were reviewed from January to December 2023. A study form was used to collect the results of total hemoglobin, reticulocyte hemoglobin, ferritin, and C-reactive protein (CRP) levels. Bone marrow hemosiderin values, which were used as the standard test to determine iron deficiency, were also collected. Anemia was defined in women as hemoglobin levels less than 11 g/dL and in men less than 12 g/dL. An elevated CRP value greater than 10 mg/L was considered indicative of an inflammatory state. Participants were divided into two groups based on hemosiderin levels: the iron deficiency anemia group (hemosiderin ≤ 2+) and the non-iron deficiency anemia group (hemosiderin > 2+). Results: The frequency of iron deficiency anemia was 77.5%, and the frequency of inflammatory states was 76.8%. No significant differences in reticulocyte hemoglobin levels were found according to gender or age group in patients with iron deficiency anemia. According to the ROC analysis, the area under the curve (AUC) for reticulocyte hemoglobin was 0.525 (p=0.679) and for ferritin, 0.624 (p=0.041). The optimal cutoff point for reticulocyte hemoglobin was 33.9 pg, with a sensitivity of 43% and specificity of 70.4%. For ferritin, the cutoff value was 501 ng/mL, with a sensitivity of 48.4% and specificity of 77.8%. Reticulocyte hemoglobin levels were significantly affected by inflammation, unlike ferritin. Conclusion: Reticulocyte hemoglobin and ferritin have poor diagnostic efficacy in patients with iron deficiency anemia who present an inflammatory state.