Ret-Y a measure of reticulocyte size: A sensitive indicator of iron deficiency anemia

Thomas S. Kickler, Michael J Borowitz, R. E. Thompson, N. Charintranomt, R. Law

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


In this study the size of reticulocytes was measured, reticulocyte-Y (Ret-Y), to distinguish iron deficiency anemia from the anemia of chronic disease using a Sysmex XE2100 cell counter. We evaluated this parameter prospectively in 100 patients seen for the evaluation of anemia. A clinical diagnosis of iron deficiency anemia or anemia of chronic disease was made on the basis of a complete blood count, examination of the peripheral smear, and serum ferritin along with a history and physical examination. We analyzed the sensitivity and specificity of the Ret-Y in relationship to the clinical diagnosis. We also measured serum transferrin receptor levels to use as the gold standard laboratory test for iron deficiency against which we compared the Ret-Y. In 40 normal individuals with normal serum ferritin and transferrin receptor levels the mean Ret-Y was 1874 ± 178 (1 SD). The mean Ret-Y in the anemia of chronic disease group (n = 62) was 1722 ± 162, not significantly different from normal. The mean Ret-Y value among iron-deficient patients (n = 38), was 1407 ± 136 (P < 0.01 vs. the anemia of chronic disease group's Ret-Y value). Receiver operator curves showed that Ret-Y correlated closely to the serum transferrin receptor and was superior to the mean corpuscular volume, and ferritin level, in differentiating the type of anemia. The Ret-Y parameter has the highest overall sensitivity and specificity of the panel of tests routinely used in differentiating iron deficiency anemia from anemia of chronic disease.

Original languageEnglish (US)
Pages (from-to)423-427
Number of pages5
JournalClinical and Laboratory Haematology
Issue number6
StatePublished - Dec 2004


  • Anemia
  • Cell counting
  • Reticulocyte parameters

ASJC Scopus subject areas

  • Hematology


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