Reticulocyte hemoglobin content (CHr): early indicator of iron deficiency and response to therapy [letter]

New erythrocyte and reticulocyte parameters on CELL‐DYN Sapphire: analytical and preanalytical aspects

“…As expected, we also found increased hypochromic RBC and decreased MCHr in patients with chronic renal failure. These results all are in accordance with previous literature reports (Macdougall et al, 1992;Brugnara et al, 1994;Fishbane et al, 1997;Noronha & Grotto, 2005;Bovy et al, 2007;KDOQI 2007;Urrechaga, 2008Urrechaga, , 2009Maconi et al, 2009;Jonckheere et al, 2010;Miwa et al, 2010), but need to be confirmed in future studies specifically designed for investigating the clinical utility of the CELL-DYN Sapphire-extended RBC parameters. This also holds true for neonates, who showed results indicative of iron-restricted erythropoiesis in our limited data set (Table 3).…”

“…It has been demonstrated that these extended RBC parameters have evident clinical utility and, in certain conditions, even provide information on erythropoiesis that was previously inaccessible. For example, the percentage hypochromic RBC is a highly sensitive parameter for detecting functional iron deficiency in patients with chronic renal failure on hemodialysis (Macdougall et al, 1992), whereas MCHr (mean Hgb content of reticulocytes) is an early indicator of iron deficiency and of successful response to therapy (Brugnara et al, 1994). Hyperchromic RBC can be used as a diagnostic tool and an indicator of disease severity in hereditary spherocytosis (Gilsanz, Ricard & Millan, 1993;Pilar Ricard & Gilsanz, 1996).…”

Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states

“…Measurements of reticulocyte hemoglobin content have been shown to provide useful information in diagnosing FID during r-HuEPO therapy (Brugnara et al, 1994a), iron-deficient states in infancy (Brugnara et al, 1999;Ullrich et al, 2005) and response to iron therapy (Brugnara et al, 1993(Brugnara et al, , 1997Thomas & Thomas, 2002). A limitation of this approach has been the fact that these parameters were available only on Bayer instruments.…”

“…By directly measuring the mean hemoglobin content (pg) of red blood cell (RBC) precursors (Reticulocytes), early stages of iron deficiency may be identified, at a time that other traditional biochemical parameters are non-informative (Brugnara, 2000(Brugnara, , 2003. The measurement of reticulocyte hemoglobin content is a direct assessment of the incorporation of iron into erythrocyte hemoglobin and thus a direct estimate of the recent functional availability of iron into the erythron (Brugnara et al, 1994c(Brugnara et al, , 1997Buttarello et al, 2004). The mean intracellular hemoglobin content of erythrocytes (MCH) is an all inclusive measure of both the availability of iron over the preceding 90-120 days, and of the proper introduction of iron into intracellular hemoglobin (Brugnara et al, 1994b,c).…”

Reticulocyte hemoglobin equivalent to detect thalassemia and thalassemic hemoglobin variants

“…Measurement of hemoglobin in reticulocytes has proved useful for the diagnosis and follow-up of IDA [11], while its use in hemoglobinopathies has been less extensively elaborated [12][13][14][15][16]. Reticulocyte hemoglobin is available on both Advia (reticulocyte hemoglobin content; CHr) [17][18][19] and on Sysmex (reticulocyte hemoglobin equivalent; Ret-He, formerly Ret-Y) [20][21][22][23][24]. The two reticulocyte hemoglobin methods produce essentially similar results [25].…”