Dr Syirah Nazirah binti Mohd Tajuddin received her medical degree from Universiti Putra Malaysia (UPM) in 2007. She later completed her speciality in Doctor of Pathology (Haematology) at Universiti Kebangsaan Malaysia (UKM) in 2016. She started her career as a medical officer and has been working as a pathologist since 2012. Dr Syirah is a very active member of Persatuan Diabetes Malaysia, the College of Pathologists, the Academy Medicine of Malaysia, and the International Society of Thrombosis and Haemostasis, and many others. She has become a life member for Malaysian Society of Haematology since 2020, and member of the National Kidney Foundation since 2017. Currently, she is the chairperson for Jawatankuasa Penolakan Jabatan Patologi, Hospital Tuanku Jaafar. Moreover, she has conducted numerous research studies in the Haematology field since 2015. Dr Syirah has been awarded with the Anugerah Perkhidmatan Cemerlang (Excellent Service Awards) during her service in Hospital Batu Pahat in 2011 and Hospital Tuanku Jaafar in 2018.

Abstract

Iron deficiency anaemia is the most common cause of anaemia worldwide, affecting mainly women, children and the elderly. 85% of anaemia cases in Malaysia are caused by iron deficiency. Iron is fundamental for our body’s normal physiological function. Untreated iron deficiency anaemia can lead to many health issues, so early diagnosis and prompt treatment is crucial. However, the common iron study which includes serum ferritin, serum iron, and total iron biding capacity markers, is not without limitations. The gold standard  for diagnosing iron deficiency, a bone marrow Perls Prussian blue staining study, is in fact very invasive and expansive. With the advancement of technology, the reticulocytes Hb content can be measured by flowcytometry. Reticulocytes have a short life span in the peripheral blood, lasting about 1-2 days, and they have reduced levels of haemoglobin production during iron deficient erythropoiesis. Therefore, its Hb contents can be a good indicator of iron deficiency. The assessment of Hb content in reticulocytes includes reticulocyte Hb equivalent (RET-He) and reticulocyte Hb content (CHr). RET-He, which can be quantified in the same sample used for the full blood count test by the current automated haematology analysers, provides a measure of iron bioavailability during erythropoiesis, as well as a good index to assess treatment response.