Performance Characteristics of Percentage of Hypochromic Red Cells in the Detection of Latent Iron Deficiency in Women with Menometrorrhagia

BACKGROUND Menometrorrhagia is a common cause of iron deficiency anemia (IDA) in women of reproductive age group. Latent iron deficiency (LID) is a precursor stage of IDA in which there is evidence of iron deficiency without anemia. LID causes cognitive impairment, impaired immunity and reduced work capacity which can be corrected by iron supplementation. Conventional biochemical and hematological parameters have limitations in the diagnosis of LID. This study was done to assess the performance characteristics of percentage of hypochromic red cells (% HYPO) in the detection of LID in women with menometrorrhagia. METHODS This study was done on 226 women attending the Gynaecology OP clinic of our institution, of which 183 had menometrorrhagia, and the remaining being controls. After testing for conventional hematological indices and serum ferritin, the subjects were divided into 3 groups: a LID group, an IDA group, and a control group without iron deficiency. ROC curve analysis was performed to assess % HYPO and other conventional hematological parameters in identifying LID. RESULTS Most hematological indices were within normal ranges in LID population, thus limiting their utility. The AUC for % HYPO in LID population was 0.736 with an optimum cut-off of 8.7 corresponding to a sensitivity and specificity of 62.3 and 76.74 respectively. CONCLUSIONS % HYPO is a sensitive, specific, fast, cheap, and practical and thus serves as a better predictive marker than conventional biochemical and hematological parameters in the detection of LID.