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

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, which is calculated using the HGB and RBC parameters that are measured as part of a complete blood count (CBC) by the HGB and RBC/PLT channels in Sysmex instruments. 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. While mature RBC are separated from immature cells in the RET scattergram based on fluorescence intensity (which is directly proportional to RNA content), hypo-haemoglobinised and hyper-haemoglobinised red cells are classified based on their high-angle forward-scattered light signal (which, as explained above, is directly proportional to haemoglobin content).

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 research parameters on XN-Series analysers that have the RET channel. In the XT-4000i and XE-5000 analysers these research parameters are measured with the RET channel and named %HYPO-He and %HYPER-He. Research parameters should not be used for in vitro diagnostics.

Immature Granulocyte
(IG) count

Immature Platelet Fraction
(IPF)

Nucleated red blood cells
(NRBC)

Reticulocyte haemoglobin
equivalent

Neutrophil granularity
(NEUT-SSC)

Microcytic and macrocytic
red blood cells
(%MicroR, %MacroR)

Fragmented
red blood cells (FRC*)

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