Schistocytes Evaluation in Iron Deficiency: An Assessment Adopted From ICSH Nomenclature Guideline

Introduction: The diagnostic validity of schistocyte count in diagnosing iron deficiency (ID) in the microcytic population is critical. The purpose of this study is to identify the correlation between schistocyte count and iron parameters and the performance of schistocyte count in diagnosing ID in the microcytic population. Methods: Out of 805 general checkup participants, 65 subjects consisting of 17 males and 48 females aged 18-56 years had Mean Corpuscular Value (MCV) < 80 fL. Serum ferritin examination showed 25 patients with ID and the other 40 subjects without ID. Result: There was a significant difference in the schistocyte count between the two groups (p < 0.001). Correlation analysis obtained a significant relationship between schistocyte count and serum ferritin (r = -0.67, p < 0.001). The receiver operating characteristic (ROC) curve analysis provided an area under the curve (AUC) of schistocyte count of 0.827, with a sensitivity of 80 and specificity of 75 for a cutoff of 0.75. Conclusion: Schistocyte count has a significant correlation with iron parameters and can be used as a marker for ID in the microcytic population. Health facilities that do not have access to iron parameters examination can perform a schistocyte count. Copyright© 2025 Tri Ratnaningsih et al. Anemia published by John Wiley & Sons Ltd.