title: Detection of human erythrocytes influenced by iron deficiency anemia and thalassemia using atomic force microscopy.
abstract: OBJECTIVE
  Iron deficiency anemia (IDA) and thalassemia (THAL) are two types of microcytic anemia, and both of these conditions disturb the morphology and function of erythrocytes at the molecular level. The ability to distinguish between thalassemic and iron deficiency anemia microcytosis has important clinical implications. The purpose of this study was to show that pathophysiological changes to erythrocytes could be detected at the nanometer scale, which is important for the early diagnosis of anemia and for distinguishing between IDA and THAL.
  
  
  METHODS
  Blood samples were taken from six healthy volunteers and six patients with either iron deficiency anemia or thalassemia. Changes in the morphological of erythrocytes were studied at the nanometer level using atomic force microscopy (AFM).
  
  
  RESULTS
  There were dramatic overall shape and surface membrane deformations of the erythrocytes associated with iron deficiency anemia and thalassemia compared to healthy erythrocytes. Healthy and pathological erythrocytes of iron deficiency anemia and thalassemia could be distinguished by the morphologic parameters of width, length, the ratio of length to width, valley, peak, valley-to-peak, standard deviations, and surface fluctuation. These AFM parameters of erythrocyte morphology differed greatly between iron deficiency anemia and thalassemia.
  
  
  CONCLUSIONS
  AFM was found to be an extremely useful tool for detecting and distinguishing between iron deficiency anemia and thalassemia. Erythrocyte morphology is an important determinant for diagnosing and distinguishing IDA and THAL.
authors.affiliation: Department of Hematology, Guangzhou First Municipal People's Hospital Affiliated to Guangzhou Medical College, Guangzhou 510180, PR China. jnzhangyuping@163.com
authors.forename: Yuping
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Shunqing
authors.initials: S
authors.lastname: Wang
authors.forename: Caixia
authors.initials: C
authors.lastname: Wang
authors.forename: Jianjin
authors.initials: J
authors.lastname: Xie
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Chen
authors.forename: Yanli
authors.initials: Y
authors.lastname: Xu
authors.forename: Ping
authors.initials: P
authors.lastname: Mao
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000473:pathology*; D002462:Cell Membrane / Q000648:ultrastructure; D048430:Cell Shape; D003937:Diagnosis, Differential; D004912:Erythrocytes / Q000473:pathology* / Q000648:ultrastructure; D006801:Humans; D018625:Microscopy, Atomic Force / Q000379:methods*; D013499:Surface Properties; D013789:Thalassemia / Q000175:diagnosis* / Q000473:pathology*