title: The diagnostic accuracy of the percentage of hypochromic red blood cells (%HYPOm) and cellular hemoglobin in reticulocytes (CHr) in differentiating iron deficiency anemia and anemia of chronic diseases.
abstract: BACKGROUND
  The percentages of hypochromic red blood cells (%HYPOm) and cellular hemoglobin in reticulocytes (CHr) are suggested to be useful screening markers of iron deficiency. The aim of this study was to investigate the diagnostic accuracy of %HYPOm and CHr in differentiating iron deficiency anemia (IDA) and anemia of chronic disease (ACD).
  
  
  METHODS
  The retrospective population consisted of 58 IDA patients, 129 ACD patients and 63 controls, on whom bone marrow examination and blood count with %HYPOm and CHr had been performed. Receiver operating characteristic (ROC) analyses with area under the ROC curves (AUC) were used as statistical tests.
  
  
  RESULTS
  AUCs for differentiating the groups using %HYPOm were as follows: IDA vs. controls 0.99, ACD vs. controls 0.85 and IDA vs. ACD 0.88. AUCs for CHr in distinguishing the groups were as follows: IDA vs. controls 0.95, ACD vs. controls 0.65 and IDA vs. ACD 0.83.
  
  
  CONCLUSIONS
  IDA and ACD patients were efficiently differentiated by using %HYPOm and CHr. Additionally, %HYPOm was higher and CHr was lower in IDA patients and in ACD patients than in controls. Thus, %HYPOm is higher and CHr is lower not only in absolute iron deficiency, but also when iron availability for erythropoiesis is restricted.
authors.affiliation: Department of Clinical Chemistry, University of Eastern Finland, Eastern Finland Laboratory Centre, Kuopio, Finland. mari.ervasti@uef.fi
authors.forename: Mari
authors.initials: M
authors.lastname: Rehu
authors.forename: Susanna
authors.initials: S
authors.lastname: Ahonen
authors.forename: Kari
authors.initials: K
authors.lastname: Punnonen
mesh_terms: D000740:Anemia / Q000097:blood / Q000150:complications*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis*; D002908:Chronic Disease; D004906:Erythrocyte Count; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D012372:ROC Curve; D015203:Reproducibility of Results; D012156:Reticulocytes / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins