Application of Haemocytometry in Combination with Reticulocyte Count and Red Cell Zinc Protoporphyrin for Appropriate Classification of Microcytic Anaemia

• Application of Haemocytometry in Combination with Reticulocyte Count and Red Cell Zinc Protoporphyrin for Appropriate Classification of Microcytic Anaemia

AUTHOR(S)

Piet.C.M. BARTELS, Marianne SCHOORL, and Margreet SCHOORL

Department for Clinical Chemistry, Haematology and Immunology, Medical Center Alkmaar

SUMMARY

Haemocytometric parameters such as MCV, erythrocyte and reticulocyte counts, RDW-SD, and ZPP/Hb ratio are considered to be valuable for discriminating between iron deficiency anaemia and thalassaemia syndromes in subjects with microcytosis. ZPP/Hb ratio values are obviously increased in patients with iron deficiency and, to a lesser degree, in some subjects with α - or ß-thalassaemia trait. With regard to screening for detection of thalassaemia syndromes or iron deficiency MCV is recommended as an initial test. Subsequent application of the discriminant formula 2 x RDW ( fL ) - 5 x RBC( x 10¹²/L ) - 250 x reticulocytes ( x10¹²/L ) + 30 x ZPP/Hb ratio ( µmol/mol Hb ) yields appropriate classification in 90% of subjects with iron deficiency, α-thalassaemia or ß-thalassaemia.

KEY WORDS

Automted Hematology Analyzer, XE-2100, Iron Deficiency, Thalassemia, Erythrocytes, MCV, Reticulocytes, Red Cell Distribution Width ( RDW ), Zinc Protopohyrin/Hemoglobin
( ZPP/Hb ) Ratio