{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T01:03:02Z","timestamp":1784595782589,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Iron deficiency anemia (IDA) diagnosis in cirrhotic patients is challenging due to the confounding effects of inflammation and altered iron metabolism. Conventional markers, such as the iron profile, may be unreliable in this population. This study aimed to evaluate the diagnostic performance of reticulocyte hemoglobin content (CHr), percentage of microcytic red blood cells (%MicroR), and percentage of hypochromic red blood cells (%HypoR) for the diagnosis of IDA in cirrhotic patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four groups were included in this cross\u2010sectional study: healthy controls, IDA non\u2010cirrhotic, IDA cirrhotic, and non\u2010IDA cirrhotic patients. Complete blood counts and reticulocyte indices were analyzed using a Sysmex XN\u2010 1000 hematology analyzer, and receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of the studied indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CHr demonstrated the highest diagnostic performance, with an area under the curve (AUC) of 0.925 at a cut\u2010off value of \u2264\u200925.7\u2009pg. %MicroR also demonstrated strong discriminative ability (AUC\u2009=\u20090.906) at a cut\u2010off of &gt;\u200910.8%, whereas ferritin showed good diagnostic performance (AUC\u2009=\u20090.858) at a cut\u2010off of \u2264\u2009101\u2009\u03bcg\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CHr demonstrated excellent diagnostic performance and may serve as a valuable adjunctive marker for assessing iron status in cirrhotic patients, outperforming ferritin and other automated red blood cell indices. These findings support the potential role of reticulocyte indices as valuable tools for diagnosing IDA in cirrhosis, where conventional iron markers may be unreliable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70202","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:34:14Z","timestamp":1784594054000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of Automated Reticulocyte and Red Cell Indices for Detecting Iron Deficiency Anemia in Cirrhotic Patients"],"prefix":"10.1111","author":[{"given":"Sahar MA","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Clinical Pathology Department National Liver Institute, Menoufia University  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asmaa Ahmed Abd\u2010EL","family":"Gawad","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department National Liver Institute, Menoufia University  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olfat M.","family":"Hendy","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department National Liver Institute, Menoufia University  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila Shehata","family":"Dorgham","sequence":"additional","affiliation":[{"name":"Epidemiology and Preventive Medicine Department National Liver Institute, Menoufia University  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Abdelsameea","sequence":"additional","affiliation":[{"name":"Hepatology and Gastroenterology Department National Liver Institute, Menoufia University  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nessren Mohammed Bahaa","family":"El deen","sequence":"additional","affiliation":[{"name":"Hepatology, Gastroenterology and Infectious Disease Department Al\u2010Azhar University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3098-5029","authenticated-orcid":false,"given":"Sally S.","family":"Mandour","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department National Liver Institute, Menoufia University  Shebeen El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14988"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14229"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.4653"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.02.021"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12787"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102893.2012.01647.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9051263"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.07.008"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2019.07.005"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1401038"},{"key":"e_1_2_11_13_1","first-page":"128","article-title":"Prevalence of Iron Deficiency Anemia in Children With Liver Cirrhosis: A Cross\u2010Sectional Study","volume":"9","author":"Zareifar S.","year":"2015","journal-title":"International Journal of Hematology\u2010Oncology and Stem Cell Research"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13211"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24981"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/MEG.0000000000000247","article-title":"Abnormal Serum Iron Markers in Chronic Hepatitis B Virus Infection May Be Because of Liver Injury","volume":"27","author":"Mao W.","year":"2015","journal-title":"European Journal of Gastroenterology & Hepatology"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jhep.2014.03.027","article-title":"Serum Ferritin Predicts Early Mortality in Patients With Decompensated Cirrhosis","volume":"61","author":"Maiwall R.","year":"2014","journal-title":"Journal of Hepatology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1002\/hep.23537","article-title":"Serum Ferritin Concentration Predicts Mortality in Patients Awaiting Liver Transplantation","volume":"51","author":"Walker N. 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