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Ann Hematol (2012) 91:14271434 DOI 10.1007/s00277-012-1467-5
ORIGINAL ARTICLE
Asymptomatic elevation of the hyperchromic red blood cell subpopulation is associated with decreased redcell deformability
Jeremy W. Deuel & Hans U. Lutz & Benjamin Misselwitz &
Jeroen S. Goede
Received: 2 March 2012 /Accepted: 29 March 2012 /Published online: 18 April 2012 # Springer-Verlag 2012
Abstract Hyperchromasia of the red blood cells (RBC), defined as an elevation of the hyperchromic subpopulation, has been described for various medical conditions. However, neither the association of hyperchromasia with an altered RBC membrane nor with other medical conditions has been investigated in a systematic way so far. Since the percentage of hyperchromic RBC is measured on a routine basis by many hematologic laboratories, we evaluated the predictive value of this parameter for the detection of RBC disorders. An extensive workup of all patients undergoing standard hematogram during a period of 6 months at our institution with a fraction of hyperchromic RBC larger than 10 % was collected by reviewing the medical history and performing osmotic gradient ektacytometry on RBC from a part of these patients. Thirty-two thousand two hundred twenty-six individuals were screened; of which, 162 (0.5 %) showed more than 10 % hyperchromic RBC. All of the patients examined by ektacytometry featured abnormal membrane deformability. Hereditary spherocytosis was found in 19 out of these 32 patients, in most cases unknown to the patient and currently asymptomatic. Another 17.9 % of the patients with an elevated subpopulation of hyperchromic RBC suffered from viral
infection (human immunodeficiency virus, hepatitis). Our study shows that an elevated proportion of hyperchromic erythrocytes larger than 10 % is associated with both hereditary and acquired RBC membrane disorders and further follow-up should be considered.
Keywords Hyperchromasia . Spherocytosis . Red blood cells . Membrane
Introduction
Hyperchromasia of the red blood cells (RBC) is a common feature of various conditions and has been described especially for hereditary spherocytosis (HS) [1] but also for various others, such as listed in Table 1 [24]. Hyperchromasia, defined as an elevated percentage of hyperchromic RBC, can be predictive for an altered RBC membrane even in the absence of an elevated mean cellular hemoglobin concentration (MCHC) [5].
HS is a common form of hereditary RBC membranopathies. Symptoms range from asymptomatic forms to...