The Advia 120 red blood cells and reticulocyte indices are useful in diagnosis of iron-deficiency anemia.

We have investigated the red blood cell (RBC) and reticulocyte indices of the Advia 120 hematology system in assessment of body iron stores as well as in diagnostics of iron-deficiency anemia in two separate study populations. The first study population consisted of a total of 34 apparently healthy females who were found to be anemic (Hb<125gL1) in a screening test. The anemic subjects were classified on the basis of plasma transferrin receptor (TfR) concentration into an iron-deficiency anemia group (TfR concentration 2.4mgL1, n=14) and an adequate iron stores group (TfR concentration <2.4mgL1, n=20). Another study population consisted of 95 hospital patients of whom 31 had depleted iron stores according to TfR concentration. The same population was classified further on the basis of hemoglobin value (Hb<125gL1 for females, Hb<135gL1 for males) into patients with iron-deficiency anemia (n=21) and those with anemia together with adequate iron stores (n=44). In the population of young anemic female students the percentage of hypochromic RBC (%HYPOm) had a remarkably high ROC AUC of 0.98 when evaluating the diagnostic accuracy for the distinction between the patients with iron-deficiency anemia and those with anemia and adequate iron stores. Also, among the hospitalized patients %HYPOm had the highest ROC AUC of 0.77. The diagnostic efficiency provided by the red blood cell and reticulocyte indices was considerably lower in the heterogeneous group of hospitalized patients than in the group of female students. Nevertheless, the advanced RBC and reticulocyte indices may prove to be useful tools in the evaluation of iron status and diagnosis of iron-deficiency anemia.