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The microcytic (MicroR*) and macrocytic (MacroR*) red blood cell populations

Red blood cells (RBC) and platelets (PLT) are counted in the RBC/PLT channel using the sheath flow DC (direct current) detection method. Hydrodynamic focussing is used so that only single cells pass through the detector, and the resulting RBC size distribution shows a nearly Gaussian distribution. Values for the MicroR and MacroR parameters are obtained from either end of the RBC histogram. The RBC histograms of samples with microcytic RBC are shifted to the left and often exhibit a shoulder on the left due to an increase in small RBC. In contrast, samples with macrocytic RBC generate histograms exhibiting a longer slope on the right. By applying two distinct discriminators at the lower and upper area of the histogram, a microcytic and a macrocytic population of red blood cells can be determined, and the resulting parameters reflect the microcytic (MicroR) and macrocytic RBC (MacroR) as a percentage of all red blood cells.
In certain diseases (for example, in myelodysplastic syndrome), patients may have an MCV value that is within the reference range despite having an increased MicroR or MacroR. The parameters MicroR and MacroR are therefore useful to narrow down the possible causes of anaemia.

Figure: Microcytic RBC (MicroR, upper panel) and macrocytic RBC (MacroR, lower panel) in the RBC histogram

*The parameters MicroR and MacroR are research parameters on XN-Series analysers and part of the complete blood count (CBC). On the X-Class analysers XT-4000i and XE-5000 they are named %MicroR and %MacroR. Research parameters should not be used for in vitro diagnostics.


Advanced Clinical Parameters

Immature Granulocyte
(IG)

Immature Platelet Fraction
(IPF)

Nucleated red blood cells
(NRBC)

Reticulocyte haemoglobin
equivalent (RET-He)


Research Parameters*

Neutrophil granularity
(NEUT-SSC)

Hypochromic and hyperchromic
red blood cells
(%HYPO-He, %HYPER-He)

Fragmented
red blood cells (FRC*)

* Research parameters are not released by Sysmex for routine in vitro diagnostics (yet) and should therefore be validated and documented under the main responsibility of a clinician/health professional before such diagnostic decisions are made.

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