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Percentage of hypo-haemoglobinised red cells (HYPO-He) and hyper-haemoglobinised red cells (HYPER-He)

What are HYPO-He and HYPER-He used for?

Together with other parameters, HYPO-He is used in RBC indices to distinguish between iron defiency anaemia and thalassaemia.

The use of HYPO-He as well as MicroR is recommended in nephrology guidelines such as the European Best Practice Guidelines (EBPG), National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF KDOQI).

How are HYPO-He and HYPER-He determined?

HYPO-He and HYPER-He are parameters analysed in the reticulocyte (RET) channel. They are derived from the haemoglobin content of all mature RBC (RBC-He), which can be calculated based on the high-angle forward scatter (FSC). The FSC signal is converted into picograms (pg) using a proprietary algorithm and in healthy individuals the resulting RBC-He value is comparable to the mean corpuscular haemoglobin (MCH) value. Subsequently, this RBC-He value is used to determine HYPO-He and HYPER-He.

HYPO-He is the percentage of RBC with cellular haemoglobin content lower than 17 pg, whereas HYPER-He is the percentage of RBC with cellular haemoglobin content higher than 49 pg.

Figure: each cell is plotted in the RET scattergram based on its fluorescence intensity (x-axis) and its high-angle forward-scattered light signal (y-axis), which reflects characteristics of both cell size and cellular content. The left panel shows a sample from a healthy individual with HYPO-He less than 1% and the right panel shows a sample with HYPO-He more than 60%

HYPO-He and HYPER-He are diagnostic parameters on XN-Class analysers that have the RET channel. *

 

*In the XT-4000i and XE-5000 analysers these are research parameters that are derived from the RET channel and named %HYPO-He and %HYPER-He. Research parameters should not be used for in vitro diagnostics.

Immature Granulocytes
(IG)

Immature Platelet Fraction
(IPF# and %)

Nucleated Red Blood Cells
(NRBC)

Reticulocyte haemoglobin
equivalent (RET-He)

Neutrophil Granularity
and Reactivity
(NEUT-GI, NEUT-RI)

Microcytic and Macrocytic
Red Blood Cells
(MicroR, MacroR)

Reactive and Antibody-
synthesizing Lymphocytes
(RE-LYMP, AS-LYMP)

Fragmented
red blood cells (FRC*)

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