Reevaluation of the utility of mean cell hemoglobin (MCH) screening in infants for iron deficiency.

Iron deficiency (ID) at the stage of latent deficiency (LID) or frank anemia (IDA) is still common in pediatric practice. We have assessed the prevalence of LID and IDA in an infant population with an age range of 9-11 months, in Paris. Red cell indices, hemoglobin level, serum iron, transferrin saturation and serum ferritin levels were assayed. There was considerable prevalence of ID as 82% of the children exhibited low levels in one of the above parameters. We found low mean cell hemoglobin (MCH) to be predictive of LID in one third of cases. Since MCH value is routinely available to the physician, it appears that a close examination of this red cell index should allow for the diagnosis of ID in a large number of children at risk, without the need to resort to more elaborate and expensive laboratory tests.