Difference of RET and RBC haemoglobin content (Delta-He)
What is Delta-He parameter?
The Delta-He parameter reflects the difference between the haemoglobin equivalent of reticulocytes (RET-He) and the haemoglobin content of mature red blood cells (RBC-He). Under physiological conditions, the value of the diagnostic parameter is positive because the haemoglobin content in reticulocytes is higher than in mature red blood cells. Negative values result from a lower degree of haemoglobinisation in newly formed reticulocytes compared to mature erythrocytes. It is available from a routine laboratory analysis of an EDTA blood sample.
How is Delta-He calculated?
Delta-He is calculated by subtracting RBC-He from RET-He. RET-He is a diagnostic parameter obtained from Sysmex’s haematology analysers equipped with a RET channel. In the RET channel, all reticulocytes are stained with a fluorescent dye and counted. The population in the area of high fluorescence intensity is separated as reticulocytes and the RET-He parameter is derived from the mean forward scatter light of reticulocyte population. Similarly, RBC-He is a diagnostic parameter and it is derived from the mean forward scattered light of the RBC population in the RET scattergram.
Reference ranges (adults)
Delta-He: 1.2 - 3.6 pg (0.07 - 0.22 fmol) [1]
Statement
Our results emphasize the diagnostic potential of Delta-He regarding the rapid detection of a bacterial infection in a patient’s blood, which is comparable to the diagnostic value of CRP or PCT. (Zimmermann M et al. 2021)
Benefits
These clinical benefits were reported in the scientific literature for the Delta-He parameter:
- Serves as a marker of impaired haemoglobinisation of newly formed reticulocytes occurring during inflammatory processes, which helps to differentiate between different disease-specific types of anaemia [2].
- It is part of the ‘Haema plot’ tool, developed for differential diagnosis and disease monitoring in various types of disease-specific anaemia and for identifying non-adherent patients or inadequate therapy [2].
- Delta-He was found to be associated with inflammation, response to erythropoietin stimulating agents and mortality risk in peritoneal dialysis patients [3].
- The Delta-He parameter supports the detection of bacterial infection in the patient’s blood [4,5].
- Delta-He has demonstrated promising supportive capabilities to diagnose iron deficiency anaemia and functional iron deficiency in critically ill patients in the ICU [6].
References
[1] L van Pelt J et al. (2022): Reference intervals for Sysmex XN hematological parameters as assessed in the Dutch Lifelines cohort. Clin Chem Lab Med 60(6): 907–20.
[2] Weimann A et al. (2016): Delta-He, Ret-He and a New Diagnostic Plot for Differential Diagnosis and Therapy Monitoring of Patients Suffering from Various Disease-Specific Types of Anemia. Clin Lab. 62(4): 667–77.
[3] Danielson K et al. (2014): Delta-He: a novel marker of inflammation predicting mortality and ESA response in peritoneal dialysis patients. Clin Kidney J. 7(3): 275–81.
[4] Zimmermann M et al. (2021): Delta-Hemoglobin Equivalent and Granularity Index as Cell-Derived Biomarkers for the Detection of Bacterial Infections. Clin Lab. 67(8).
[5] Henriot I et al. (2016): New parameters on the hematology analyzer XN-10 (SysmexTM) allow to distinguish childhood bacterial and viral infections. Int J Lab Hematol. 39(1): 14–20.
[6] Zuther M et al. (2022): Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers. Cells. 12(1): 140.
[7] Zuther M et al. (2022): Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers. Cells. 12(1): 140.
