title: Percentage of hypochromic erythrocytes as a potential marker of iron availability.
abstract: BACKGROUND
  The percentage of hypochromic red cells (% Hypo-He) is now available on the Sysmex analyzer XE 5000 (Sysmex Corporation, Kobe, Japan). In this study the reliability of % Hypo-He in the assessment of iron status in the presence of inflammation is investigated.
  
  
  METHODS
  Ninety healthy subjects, 91 patients with iron deficiency anemia (IDA) previous to therapy, 65 patients with chronic kidney disease (CKD), 57 patients with anemia of chronic diseases (ACD) and 28 patients with storage iron deficiency (ACD/IDA) receiving therapy were analyzed. Pearson's correlation, Independent samples t-test, receiver operating characteristic (ROC) curve analysis and Cohen's k index were applied.
  
  
  RESULTS
  % Hypo-He values inversely correlated with the blood hemoglobin (Hb) (r=-0.78) and Hb content (MHC, r=-0.75). In patients with IDA and ACD/IDA the values obtained for % Hypo-He showed no statistical difference (p=0.5037). ROC analysis results for % Hypo-He in the detection of iron deficiency defined by a serum transferrin receptor (sTfR) >21 nmol/L. The area under the curve is 0.929; cut-off 3.6%, sensitivity 91.5% and specificity 80.9%. Using the threshold 3.6% the k index obtained in comparison to sTfR was 0.64.
  
  
  CONCLUSIONS
  % Hypo-He is a reliable parameter for the detection of iron deficiency in patients with anemia in the presence of inflammation.
authors.affiliation: Hematology Laboratory, Hospital Galdakao, Usansolo, Galdakao, Spain. eloisa.urrechagaigartua@osakidetza.net
authors.forename: Eloísa
authors.initials: E
authors.lastname: Urrechaga
authors.forename: Luís
authors.initials: L
authors.lastname: Borque
authors.forename: Jesús F
authors.initials: JF
authors.lastname: Escanero
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010858:Pigmentation
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D007501:Iron