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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R.


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Potential utility of the new Sysmex XE 5000 red blood cell extended parameters in the study of disorders of iron metabolism

Eloísa Urrechaga1 / Luís Borque2 / Jesús F. Escanero2

1Hematology Laboratory, Hospital Galdakao, Usansolo, Galdakao, Vizcaya, Spain

2Department of Pharmacology and Physiology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain

Corresponding author: Dr. Eloísa Urrechaga, Hematology Laboratory, Hospital Galdakao, Usansolo, 48960 Galdakao, Vizcaya, Spain Phone: +34 94 400 7102, Fax: +34 94 400 7128,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 47, Issue 11, Pages 1411–1416, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2009.301, October 2009

Publication History

Received:
2009-04-20
Accepted:
2009-07-13
Published Online:
2009-10-12

Abstract

Background: New erythrocyte parameters are reported by the Sysmex XE 5000 analyzer. This instrument measures the hemoglobin (Hb) content of individual red cells, calculates the percentage of hypochromic red cells (%Hypo He) and the percentage of hyperchromic red cells (%Hyper He) and quantifies the proportion of marginally sized erythrocytes (%Micro R and %Macro R). The goals of the study were to establish the reference range for erythrocyte extended parameters, their value in different types of anemia and to investigate their reliability in the study of disorders of iron metabolism.

Materials: Three hundred and ninety samples were analyzed. The Kolmogorov-Smirnoff test, independent samples t-test and Pearson correlation were calculated; receiver operating characteristic (ROC) curve analysis was used to determine their diagnostic performance.

Results: The values of the four parameters studied were normally distributed and statistically different (p<0.0001) in the different groups of patients; the only exception was %Hypo He in cases of iron deficiency and thalassemia (p=0.3758). Results of ROC curve analysis for %Hypo He in the diagnosis of restricted erythropoiesis reticulocyte Hb content (reticulocyte hemoglobin content, Ret He <29 pg) were: area under the curve 0.963; cut-off 1.8%; sensitivity 98.3%; specificity 91.1%.

Conclusions: The new parameters appear to be sensitive for detecting small changes in the number of red cells with inadequate hemoglobinization and volume.

Clin Chem Lab Med 2009;47:1411–6.

Keywords: hypochromia; mature erythrocyte; microcytosis; restricted erythropoiesis

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