Early Diagnosis of Iron Deficiency in School Children: A Qatari Experience

Abstract

Objective: Iron deficiency still remains the most common nutritional deficiency throughout the world and is the leading cause of anaemia in children. Early recognition of iron deficiency, even before the development of anaemia is crucial to prevent the systemic complications of this disease. Methods: Ninety-seven school children between 5 and 16 years were stratified into prelatent iron deficiency (10 cases), latent iron deficiency (14 cases), overt iron deficiency anemia (13 cases), and controls (60 cases). All hemograms were performed on the same day of collection using the same Sysmex XE-2100 analyzer with reticulocyte indices included. Biochemical markers such serum iron, total iron binding capacity and percent saturation (calculated) in addition to serum ferritin and serum transferrin receptors were simultaneously measured. Data analysis was done using ANOVA test, generalized linear regression, and ROC curve. Results: Our study indicates that a panel based on hematologic parameters including reticulocyte hemoglobin at a cut off of ≤27 and ≤25.6, serum transferrin receptors at a cut off >0.48 and >0.68, red cell distribution width at a cut off >13.8 and >16.8 may provide an alternative to the traditional biochemical panels for the diagnosis of latent iron deficiency and overt iron deficiency anemia respectively. Conclusion: Whenever iron deficiency is thought of, a hemogram including reticulocyte hemoglobin and serum transferrin receptors would be the adequate diagnostic panel obviating the need for a more extensive one. These parameters should always be interpreted in the clinical context involving dietary habits, social standard as well as family history.