PRE AND POST IRON THERAPY ABSOLUTE RETICULOCYTE COUNT- A RELIABLE TEST WITH EARLY RESPONSE TO TREATMENT IN IRON DEFICIENCY ANAEMIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 20
Abstract
BACKGROUND Iron deficiency anaemia is usually treated using oral iron therapy as first line treatment. Several tests are available to monitor the response to oral iron treatment, but absolute reticulocyte count [ARC] is supposed to be the one showing one of the quickest responses, with an increase of ARC within 5 to 10 days of therapy initiation. Our aim is to verify that ARC is significantly increased following iron therapy and that the response is quick and cost effective. METHODS 50 adults with recently diagnosed but untreated iron deficiency anaemia were included in this prospective cohort study. Haemoglobin [Hb], RBC indices, peripheral smear and ARC were done at baseline [T0], day 7 [T1] and day 30 [T2] after the start of oral iron therapy. RESULTS Mean (SD) Hb level at T0 was 8.93 (1.41) g/dl [Hb0]. It increased to 9.22 (1.33) g/dl [Hb1] and 10.59 (1.28) g/dl [Hb2] at T1 and T2, respectively. Mean (SD) ARC level at T0 was 19.6 x 109 (12.7 x 109) /l [ARC0]. It increased to 80.15 x 109 (28.1 x 109)/l [ARC1] at T1 and then reduced to 36.08 x 109 (17.9 x 109)/l [ARC2] at T2. Using Repeated measures ANOVA, there was a statistically significant (p <0.0001) increase in mean Hb2 compared to mean Hb0 (baseline), while there was no significant rise of mean Hb1 when compared with mean Hb0. 84% showed at least 1 g/dL increase of Hb by day 30. Mean ARC1 was statistically higher (p<0.001) than mean ARC0, while mean ARC2 was significantly lower (p value<0.001) than mean ARC1. Based on Spearman correlation test, there was a positive correlation (r = 0.282, n = 50, p<0.05 - significant) between relative rise of Hb [after 30 days] and relative rise of ARC [after 7 days]. CONCLUSIONS Our study confirms that ARC is an ideal early predictor of response to iron therapy as it increases by 7th day compared with Hb which does not rise significantly till 4 weeks of therapy. Also, ARC can be done manually, requiring no special equipment and therefore cost effective especially in resource constrained settings.
Authors and Affiliations
Jonathan Arnold A. P, Dhamini Durairaj
Keywords
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- EP ID EP619062
- DOI 10.14260/jemds/2019/367
- Views 83
- Downloads 0
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