Neonatal Reference Intervals for the Complete Blood Count Parameters MicroR and HYPO-He: Sensitivity Beyond the Red Cell Indices for Identifying Microcytic and Hypochromic Disorders

To create neonatal reference intervals for the MicroR and HYPO-He complete blood count (CBC) parameters and to test whether these parameters are sensitive early markers of disease at early stages of microcytic/hypochromic disorders while the CBC indices are still normal. We retrospectively collected...

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Bibliographic Details
Published in:The Journal of pediatrics 2021-12, Vol.239, p.95-100.e2
Main Authors: Bahr, Timothy M., Christensen, Thomas R., Henry, Erick, Wilkes, Jacob, Ohls, Robin K., Bennett, Sterling T., Ward, Diane M., Pysher, Theodore J., Christensen, Robert D.
Format: Article
Language:English
Subjects:
Anemia, Iron-Deficiency - blood
Anemia, Iron-Deficiency - diagnosis
Biomarkers - blood
Humans
hypochromia
Infant
Infant, Newborn
iron deficiency
MCH
MCV
microcytosis
reference intervals
Reference Values
Reticulocyte Count - methods
Reticulocytes - chemistry
Retrospective Studies
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Summary:To create neonatal reference intervals for the MicroR and HYPO-He complete blood count (CBC) parameters and to test whether these parameters are sensitive early markers of disease at early stages of microcytic/hypochromic disorders while the CBC indices are still normal. We retrospectively collected the CBC parameters MicroR and HYPO-He, along with the standard CBC parameters, from infants aged 0-90 days at Intermountain Healthcare hospitals using Sysmex hematology analyzers. We created reference intervals for these parameters by excluding values from neonates with proven microcytic disorders (ie, iron deficiency or alpha thalassemia) from the dataset. From >11 000 CBCs analyzed, we created reference intervals for MicroR and HYPO-He in neonates aged 0-90 days. The upper intervals are considerably higher in neonates than in adults, validating increased anisocytosis and polychromasia among neonates. Overall, 52% of neonates with iron deficiency (defined by reticulocyte hemoglobin equivalent 90% upper interval (relative risk, 4.14; 95% CI, 3.80-4.53; P 90% upper interval (relative risk, 6.64; 95% CI, 6.03-7.32; P 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2021.08.002