Timothy M Bahr1, Vickie L Baer2, Robin K Ohls3, Thomas R Christensen4, Diane M Ward5, Sterling T Bennett6, Robert D Christensen3,2,7. 1. Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA. tim.bahr@hsc.utah.edu. 2. Women and Newborns Research, Intermountain Healthcare, Murray, UT, USA. 3. Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA. 4. University of Utah student, Salt Lake City, UT, USA. 5. Department of Pathology, University of Utah, Salt Lake City, UT, USA. 6. Department of Pathology, Intermountain Medical Center, Murray, UT, USA. 7. Division Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA.
Abstract
OBJECTIVE: To determine why serum ferritin and reticulocyte hemoglobin (RET-He), drawn to assess neonatal iron sufficiency, sometimes have markedly discordant results. STUDY DESIGN: Retrospective records review of five NICUs over 28 months, identifying all patients with a ferritin and RET-He within 48 h. We examined records of all who had marked discordance (one value >95th % reference interval, the other <5th %). RESULTS: Of 190 paired ferritin and RET-He measurements, 16 (8%) were markedly discordant. Fifteen of the 16 discordant samples involved a high ferritin and a low RET-He. In these, low MCV and high %Micro-R, and low MCH and high %HYPO-He were present. In total, 8 of the 15 had laboratory or clinical evidence of an inflammatory process and five had suspicion of infection documented. CONCLUSIONS: When ferritin and RET-He were discordant, erythrocyte microcytosis and hypochromasia suggested that the RET-He gave the more accurate interpretation; that iron deficiency was likely present.
OBJECTIVE: To determine why serum ferritin and reticulocyte hemoglobin (RET-He), drawn to assess neonatal iron sufficiency, sometimes have markedly discordant results. STUDY DESIGN:Retrospective records review of five NICUs over 28 months, identifying all patients with a ferritin and RET-He within 48 h. We examined records of all who had marked discordance (one value >95th % reference interval, the other <5th %). RESULTS: Of 190 paired ferritin and RET-He measurements, 16 (8%) were markedly discordant. Fifteen of the 16 discordant samples involved a high ferritin and a low RET-He. In these, low MCV and high %Micro-R, and low MCH and high %HYPO-He were present. In total, 8 of the 15 had laboratory or clinical evidence of an inflammatory process and five had suspicion of infection documented. CONCLUSIONS: When ferritin and RET-He were discordant, erythrocyte microcytosis and hypochromasia suggested that the RET-He gave the more accurate interpretation; that iron deficiency was likely present.
Authors: Timothy M Bahr; Nicholas R Carr; Thomas R Christensen; Jacob Wilkes; Elizabeth A O'Brien; Kendell R German; Robin K Ohls; Diane M Ward; Robert D Christensen Journal: Blood Cells Mol Dis Date: 2021-05-06 Impact factor: 2.372
Authors: Timothy M Bahr; Diane M Ward; Xuan Jia; Robin K Ohls; Kendell R German; Robert D Christensen Journal: Blood Cells Mol Dis Date: 2021-01-06 Impact factor: 2.372