title: Hypochromic reticulocytes, hypochromic erythrocytes and p-transferrin receptors in diagnosing iron-deficient erythropoiesis.
abstract: BACKGROUND
  The purpose of this study was to test the hypothesis that hypochromic reticulocytes, hypochromic erythrocytes and p-transferrin receptors are sensitive variables in detecting iron-deficient erythropoiesis in healthy subjects and hemodialysis patients.
  
  
  METHODS
  Study 1: Twenty-one blood donors donated 450 mL blood. During the following 2 weeks blood samples were analyzed for the variables mentioned above. Study 2: Twenty-eight blood donors received 10,000 U recombinant human erythropoietin (rHuEPO) twice in the first week or placebo, after they had donated 450 mL blood. During the following 3 weeks the blood samples were analyzed for the variables mentioned in Study 1. Study 3: Eighteen hemodialysis patients receiving rHuEPO and iron treatment had either iron treatment discontinued for 4 weeks, after which iron was resumed, or received unchanged treatment. During 8 weeks blood samples were analyzed for the variables mentioned in Study 1.
  
  
  RESULTS
  Study 1: Blood donation induced an increase in hypochromic reticulocytes of 178%, in hypochromic erythrocytes the increase was 267%, and in p-transferrin receptors 32%. Study 2: Treatment with rHuEPO induced a more pronounced increase than placebo in hypochromic reticulocytes (232% vs. 158%) and hypochromic erythrocytes (1240% vs. 300%), but not in p-transferrin receptors. Study 3: Discontinuation of iron treatment did not cause any significant differences in the variables mentioned above between the two groups, but caused a 25% decrease in p-ferritin. When iron treatment was resumed, p-ferritin increased by 19%. We found no significant changes in the control group.
  
  
  CONCLUSIONS
  Hypochromic reticulocytes, hypochromic erythrocytes and p-transferrin receptors are sensitive variables in the early detection of iron-deficient erythropoiesis in healthy subjects, but in this study the iron withdrawal period was too short to show the value of these variables in the detection of iron-deficient erythropoiesis in hemodialysis patients.
authors.affiliation: Department of Medicine and Medical Research, Holstebro Hospital, Holstebro, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Starklint
authors.forename: J Nørgaard
authors.initials: JN
authors.lastname: Bech
authors.forename: O
authors.initials: O
authors.lastname: Aagaard
authors.forename: E Bjerregaard
authors.initials: EB
authors.lastname: Pedersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000747:Anemia, Hypochromic / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D004912:Erythrocytes / Q000378:metabolism / Q000473:pathology*; D004920:Erythropoiesis; D005260:Female; D006262:Health; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D011990:Receptors, Transferrin / Q000378:metabolism*; D006435:Renal Dialysis; D012156:Reticulocytes / Q000378:metabolism / Q000473:pathology*
chemical_list: D011990:Receptors, Transferrin; D007501:Iron