الفهرس 
CONGENITAL CYANOTIC HEART DISEASEOnly 14 pages are availabe for public view
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Abstract
Children with cyanotic congenital heart disease (CCHD) have complex alterations in their whole blood composition and coagulation profile due to longstanding hypoxemia. In addition, in anemic patients especially those with microcytic iron deficiency anemia, permeability of microcytic erythrocytes decreases in comparison to normocytic cells, therefore thromboembolic and cardiovascular events are encountered more commonly.
Patients with cyanotic heart disease may have an acceptable quality of life. However, they are invariably prone to several complications. For instance, hyper viscosity, thrombocytopenia (decreased level of platelet production), blood clotting abnormalities(reduced synthesis of clotting factors and/or deranged platelet aggregation), cerebral abscess, cerebral embolism hyperuricemia (mainly due to age-related impairment of uric acid excretion in adults),and endocarditis.
In CCHD, defining anemia is difficult, as optimal hemoglobin concentration is dependent on degree of hypoxemia. Relative anemia therefore occurs at much higher hemoglobin levels than in the general population, and often goes unnoticed.
In the current study, patients’ age (group I) ranged from 6 months to 16 years with median age of 17 months, 61% (n=25) of studied patients were males and 39% (n=16) were females.
As regard the anthropometric measures, a statistically significant decrease was found in body height (cm), height SDS, weight kg and weight SDS of group I compared to group II.
In conclusion, Ret-He reported by Sysmex X2100 analyzer seems to be a preferable alternative in the routine practice. Patients with CCHD pose a real challenge for the detection of ID and IDA since their Hb and HCT may be raised in the presence of iron deficiency; hence the RET-He is a reliable marker of cellular hemoglobin content and can be used to identify the presence of iron-deficient states. It could be useful in assessing functional iron deficiency and differentiating it from true iron deficiency in CCHD patients with of cutoff value <22.8 pg/l to detect a true iron deficiency in congenital cyanotic heart disease and the cut off value of reticulated hemoglobin content to detect the functional iron deficiency in CCHD was ≤24 pg/l and therefore improve anemia management in CCHD patients and could help to guide clinicians in their iron management decisions.
Routine screening of patients with congenital cyanotic heart disease for iron deficiency anemia is recommended.
Reticulated hemoglobin content (Ret-He) used as a reliable test and simple tool for the investigation of iron deficiency anemia.
Keywords: Reticulocytic Hemoglobin Content in Patients with Congenital Cyanotic Heart Disease