Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA.
Women and Newborns Research, Intermountain Healthcare, Murray, UT, USA.
J Perinatol. 2021 Mar;41(3):619-626. doi: 10.1038/s41372-020-00845-2. Epub 2020 Oct 4.
To determine why serum ferritin and reticulocyte hemoglobin (RET-He), drawn to assess neonatal iron sufficiency, sometimes have markedly discordant results.
Retrospective records review of five NICUs over 28 months, identifying all patients with a ferritin and RET-He within 48 h. We examined records of all who had marked discordance (one value >95th % reference interval, the other <5th %).
Of 190 paired ferritin and RET-He measurements, 16 (8%) were markedly discordant. Fifteen of the 16 discordant samples involved a high ferritin and a low RET-He. In these, low MCV and high %Micro-R, and low MCH and high %HYPO-He were present. In total, 8 of the 15 had laboratory or clinical evidence of an inflammatory process and five had suspicion of infection documented.
When ferritin and RET-He were discordant, erythrocyte microcytosis and hypochromasia suggested that the RET-He gave the more accurate interpretation; that iron deficiency was likely present.
确定为什么检测血清铁蛋白和网织红细胞血红蛋白（RET-He）以评估新生儿铁充足时，有时结果会明显不一致。
对 28 个月内的 5 个 NICU 进行回顾性记录回顾，确定所有在 48 小时内进行铁蛋白和 RET-He 检测的患者。我们检查了所有差异明显（一个值>第 95 个参考区间，另一个<第 5 个）的记录。
在 190 对铁蛋白和 RET-He 测量值中，有 16 对（8%）明显不一致。在这 16 个差异较大的样本中，有 15 个铁蛋白较高而 RET-He 较低。在这些样本中，MCV 较低和 %Micro-R 较高，MCH 较低和 %HYPO-He 较高。总共，有 8 个样本有实验室或临床炎症过程的证据，有 5 个有感染的可疑记录。
当铁蛋白和 RET-He 不一致时，红细胞小细胞症和低色素性提示 RET-He 给出了更准确的解释；很可能存在铁缺乏。
