Better Test for Infant Iron Deficiency

A new blood test detects iron deficiency in infants earlier and more accurately than the commonly used hemoglobin screening test, a recent study has found.

Iron deficiency is estimated to affect nearly 10% of U.S. children one to two years of age. Early detection and treatment are important since iron deficiency can impair the mental development of infants, sometimes permanently, even before the deficiency progresses to anemia.

In the study, researchers at Children's Hospital Boston (MA, USA) compared the new test, called CHr, with the standard hemoglobin test as a screen for iron deficiency in infants. CHr measures the hemoglobin content of reticulocytes, or immature red blood cells, while the standard hemoglobin test is based on the entire population of red blood cells. Since reticulocytes are present in the bloodstream for only 24-48 hours, compared to several months for mature red blood cells, measuring reticulocyte hemoglobin content provides a more up-to-date indication of iron status, said the investigators.

In the study, 200 healthy infants nine-12 years of age underwent both tests, as well as a transferring saturation test, considered the "gold standard” for iron deficiency but impractical for routine screening. Using the optimal CHr cutoff, CHr correctly identified 83% of the iron-deficient infants, compared with only 26% identified by the current screening standard. The results were reported in the August 24/31, 2005, issue of the Journal of the American Medical Association.

"Our findings are important because, while iron deficiency can be readily treated, practitioners haven't had a simple, reliable, and practical screening test to detect it early enough,” said principal investigator Henry Bernstein, D.O., associate chief, general pediatrics, Children's Hospital Boston. "Once confirmed in larger, multicenter studies, these findings could change our preferred screening practices for the early detection of iron deficiency.” He added that the CHr test is simple, requires no extra tubes of blood to be drawn, and involves no extra cost.



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