The new mature red cell parameter, low haemoglobin density of the Beckman-Coulter LH750: clinical utility in the diagnosis of iron deficiency.
The percentage of hypochromic red cells (%Hypo) is a diagnostic tool that has been used with biochemical markers to diagnose iron disturbances and is incorporated to National Kidney Foundation KDOQI guidelines for monitoring recombinant human erythropoietin therapy. %Hypo measurement has been restricted to analysers manufactured by Siemens. Low haemoglobin density (LHD%), a new parameter provided by Beckman-Coulter, is derived from the traditional mean cell haemoglobin concentration (MCHC), using the mathematical sigmoid transformation [see equation in text]. This study aimed to establish LHD% values in the normal population and in different types of anaemia, to investigate its clinical usefulness in the study of iron status and its correlation with %Hypo. Samples from 449 patients [120 healthy individuals, 86 iron deficiency anaemia (IDA), 102 chronic kidney disease, 58 anaemia of chronic disease and 83 beta-thalassaemia carriers] were run sequentially on the LH 750 (Beckman-Coulter) and Advia 2120 (Siemens) analysers. The reliability of LHD% as a marker of iron deficiency was evaluated on a group of 152 consecutive patients with IDA. Good correlation was observed between %Hypo and LHD%, r(2) = 0.869. Receiver operating characteristic curve analysis for LHD% and the diagnosis of iron deficiency was: cut-off point 4.0%; area under the curve 0.976; sensitivity 95.2%; specificity 93.3%. There was a good level of agreement between LHD% and %Hypo. Both are suitable parameters for determining iron status and its availability for erythropoiesis, with the same clinical significance.
Urrechaga
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Haematology Laboratory, Hospital Galdakao, Vizcaya, Spain. eloisa.urrechagaigartua@osakidetza.net
D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D057205:Automation, Laboratory; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy; D012016:Reference Values; D017086:beta-Thalassemia / Q000097:blood
D006454:Hemoglobins; D004921:Erythropoietin