Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Anemia is common among children with chronic liver diseases mainly iron deficiency anemia due to gastrointestinal bleeding. Reticulocyte hemoglobin may be a novel marker for assessment of iron deficiency anemia in children. Objective: To assess validity of reticulocyte hemoglobin as a marker for detection of iron deficiency anemia among children with chronic liver diseases. Patients and methods: This cross-sectional analytical study included thirty-three patients diagnosed with chronic liver disease (CLD) who were attending the Pediatric Hepatology Outpatient Clinic at Cairo University Children Hospital during the period from October 2019 to April 2021 Informed consents were obtained willingly from patients and/or legal guardians before participating in the study. Study protocol was approved by Research Ethics Committee at Cairo university. All the included subjects were subjected to full history taking, examination and laboratory investigations including iron profile and reticulocyte hemoglobin.Results: In our study, CLD children were divided into two groups iron deficiency anaemia and non-iron deficiency anaemia according to s.ferritin level which is lower than 100ng/ml in CLD children with IDA. Among the included children with CLD the mean Reticulocytic Hb was 25.52±4.53 pg. Most of CLD children (84.8%) had Low Reticulocytic Hb. The mean Ret.Hb was significantly lower in children with IDA than children without IDA with p=0.014. The current study found statistically positive significant linear correlation between S. ferritin & Ret.Hb, r= +0.433, P= 0.012. Our study revealed that ROC curve analysis of Reticulocytic Hb, at cutoff {u2264}29.3 pg for diagnosis of iron deficiency anemia in children with CLD had an AUC of 0.824 with a sensitivity of 92.59% and a specificity of 83.33%

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