Clinical application of low hemoglobin density in screening for iron deficiency and the differential diagnosis of anemia

Abstract

To investigate the clinical usefulness of the low hemoglobin density (LHD) and other red blood cell parameters in screening for iron deficiency (ID) and distinguishing iron deficiency anemia (IDA) from other kinds of anemia. Whole blood count (CBC) and parameters of iron metabolism of the patients with ID (n = 251), IDA(n = 155), anemia of chronic disease(n = 90), renal anemia(n = 184), acute hemorrhagic anemia(n = 27) and non-anemia subjects(n = 82) were analysed by Advia 2120 hematology analyzer, Hitachi 7180 automatic biochemical analyzer, Beckman-Coulter DxI 800 immunoassay analyzer. SPSS 13.0 software was applied to anylyze data. The sensitivity of LHD in screening for ID was 67.2%, which was significantly higher than MCHC (38.8%) . There was a sensitivity of 91.2% for ID screening by combination of LHD and RDW. LHD only increased greatly in IDA (14.9%) group, while had no increase in other anemia. LHD is a reliable new marker with certain clinical usefulness. Combination of LHD and RDW is more suitable for screening ID. LHD is also a useful marker to distinguish IDA from other kinds of anemia.