{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:16:49Z","timestamp":1789845409090,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Measurement of reticulocyte hemoglobin equivalent (RET\u2010He) is rapid, convenient, and cost\u2010effective. Yet, researches on its performance in diagnosing iron deficiency with concurrent inflammation are limited. Hence, this study investigated RET\u2010He value in various states, including inflammation, and evaluated its diagnostic performance in iron status assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospectively, 953 clinical data and laboratory results\u2014complete blood count, reticulocyte count, RET\u2010He, and serum ferritin\u2014were reviewed. Patients on iron therapy were excluded. Iron status was defined by serum ferritin as the reference method. RET\u2010He among populations was investigated. Its diagnostic performance and optimal cutoff were determined by ROC analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three population groups were classified: healthy control, iron deficiency anemia (IDA), and non\u2010ID anemia. Significantly, RET\u2010He value in IDA was lower than that of healthy control, anemia of inflammation, and chronic kidney disease (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Low RET\u2010He was also observed in IDA with concomitant inflammation despite normal\u2010to\u2010high serum ferritin levels. No significant difference was observed between RET\u2010He values in pure IDA and thalassemia (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.57). ROC curve analysis revealed AUC of 0.876 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001) at cutoff 30\u00a0pg, by which IDA was discriminated with 74.2% sensitivity and 97.4% specificity. Applying cutoff \u226430\u00a0pg, IDA can be diagnosed with 96% sensitivity, 97.4% specificity, 80% PPV, and 99.6% NPV. Hence, RET\u2010He &gt;30\u00a0pg signifies a non\u2010IDA state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In addition to convenience and cost\u2010effectiveness, RET\u2010He cutoff &gt;30\u00a0pg can be potentially used to exclude IDA due to its excellent diagnostic sensitivity and specificity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.23225","type":"journal-article","created":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T13:19:41Z","timestamp":1581427181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Diagnostic performance of reticulocyte hemoglobin equivalent in assessing the iron status"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-5115","authenticated-orcid":false,"given":"Pawadee","family":"Chinudomwong","sequence":"first","affiliation":[{"name":"Department of Pathology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleeyas","family":"Binyasing","sequence":"additional","affiliation":[{"name":"Department of Pathology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rangsiri","family":"Trongsakul","sequence":"additional","affiliation":[{"name":"Department of Pathology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Paisooksantivatana","sequence":"additional","affiliation":[{"name":"Department of Pathology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-018-0178-6"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/10408363.2010.550461"},{"key":"e_1_2_6_4_1","unstructured":"Food and Agriculture Organization of the United Nations World Health Organization.Chapter 13. Iron [Internet]. Rome: food and agriculture organization.2001:195\u2010221[cited 2017 Nov 11]. Available from:http:\/\/www.fao.org\/3\/a-y2809e.pdf"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPCVZ5B0BOYJGN"},{"key":"e_1_2_6_6_1","first-page":"627","volume-title":"Williams Hematology","author":"Ganz T","year":"2016"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/6430214"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2015.11.002"},{"issue":"3","key":"e_1_2_6_9_1","first-page":"120","article-title":"The reticulocyte haemoglobin equivalent (RET_He) and laboratory screening for iron deficiency","volume":"71","author":"Poffenroth C","year":"2017","journal-title":"New Zealand J. Medical Lab. Sci"},{"issue":"11","key":"e_1_2_6_10_1","first-page":"38","article-title":"Reticulocyte hemoglobin vis\u2010a\u2010vis serum ferritin as a marker of bone marrow iron store","volume":"64","author":"Mehta S","year":"2016","journal-title":"J Assoc Physicians India"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2014.02.005"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60865-0"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-018-0046-4"},{"issue":"1","key":"e_1_2_6_14_1","first-page":"31","article-title":"Usefulness of reticulocyte hemoglobin equivalent in management of regular hemodialysis patients with iron deficiency anemia","volume":"54","author":"Dalimunthe NN","year":"2016","journal-title":"Rom J Intern Med"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-017-2212-6"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2257.2006.00812.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.18585\/inabj.v9i3.267"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.18410\/jebmh\/2016\/1105"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3284-2"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-553X.2009.01179.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjhh.2015.02.004"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30623"},{"key":"e_1_2_6_23_1","unstructured":"World Health Organization.Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations[Internet]. 2011 [cited 2017 Nov 2]. Available from:https:\/\/www.who.int\/vmnis\/indicators\/serum_ferritin.pdf"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12904"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2004.030254"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12201"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12503"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12500"},{"issue":"1","key":"e_1_2_6_29_1","first-page":"6","article-title":"Innovative haematological parameters in clinical practice","volume":"41","author":"Schoorl M","year":"2016","journal-title":"Ned Tijdschr Klin Chem Labgeneesk"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2012.09.001"},{"issue":"3","key":"e_1_2_6_31_1","first-page":"1","article-title":"The role of reticulocyte hemoglobin content in the management of iron deficiency anemia in patients on hemodialysis","volume":"10","author":"Gafor AHA","year":"2018","journal-title":"Nephro\u2010Urol Mon"},{"key":"e_1_2_6_32_1","first-page":"297","volume-title":"Rodak\u2019s Hematology: Clinical Principles and Applications","author":"Doig K","year":"2016"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.5581\/1516-8484.20140009"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.4081\/hr.2012.e24"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2014.04.007"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.23.2225"},{"issue":"1","key":"e_1_2_6_37_1","first-page":"19","article-title":"Comparison of erythrocyte and reticulocyte indices for the diagnosis of iron deficiency","volume":"86","author":"Jarc E","year":"2017","journal-title":"Zdravni\u0161ki vestnik"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2014.1000370"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.228874"},{"issue":"6","key":"e_1_2_6_40_1","first-page":"496","article-title":"Iron deficiency: diagnosis and treatment","volume":"134","author":"Dallman PR","year":"1981","journal-title":"West J Med"},{"key":"e_1_2_6_41_1","unstructured":"Centers for Disease Control and Prevention.2nd National report on biochemical indicators of diet and nutrition in the U.S. population: trace elements[Internet]. [cited 2017 Sep 17] p. 299\u2013358. Available from:https:\/\/www.cdc.gov\/nutritionreport\/pdf\/Trace.pdf"},{"issue":"1","key":"e_1_2_6_42_1","first-page":"s31","article-title":"Diagnostic accuracy of reticulocyte hemoglobin content in Thai patients with microcytic red cells as a test for iron deficiency anemia","volume":"10","author":"Chaipokam J","year":"2017","journal-title":"Asian Biomed"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjcla.23225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.23225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcla.23225","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.23225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T14:56:46Z","timestamp":1693321006000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.23225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,11]]},"references-count":41,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1002\/jcla.23225"],"URL":"https:\/\/doi.org\/10.1002\/jcla.23225","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"value":"0887-8013","type":"print"},{"value":"1098-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,11]]},"assertion":[{"value":"2019-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e23225"}}