Measurement of erythrocyte creatine might be useful for diagnosing latent hemolysis

• Published in: Clinical biochemistry 2022-09, Vol.107, p.50-54
• Main Authors: Ijima, Hiroko, Hiratani, Kazuyuki, Jinnnouchi, Hideaki, Ono, Yasuhiro, Kameyama, Masashi, Okumiya, Toshika, Koga, Masafumi
• Format: Article
• Language: English
• Subjects: Erythrocyte creatine; Glycated albumin; HbA1c; Hemolysis; Mean age of red blood cells
• ISSN: 0009-9120; 1873-2933
• DOI: 10.1016/j.clinbiochem.2022.05.007

•Latent hemolytic patients showed negative results for usual hemolysis indicators.•Erythrocyte creatine (EC) is known to reflect the mean erythrocyte age (MRBC).•Recently, we reported a formula for obtaining MRBC based on EC.•MRBC values based on EC were lower in two patients with latent hemolysis.•Measurement of EC might be useful for the diagnosis of latent hemolysis. Whereas HbA1c values are low relative to glycemia in patients with hemolytic anemia, including compensatory anemia, low HbA1c levels along with negative results for conventional hemolysis indicators have been reported in patients with latent hemolysis. Conversely, glycated albumin (GA) is a glycemic control indicator unaffected by hemolysis. Erythrocyte creatine (EC) is a hemolysis indicator that reflects the mean age of red blood cells (MRBC). We recently reported a formula for obtaining MRBC based on EC. The present study examined the usefulness of EC measurements and MRBC calculated with EC for diagnosing latent hemolysis. Two patients with latent hemolysis and low HbA1c values relative to glycemia were investigated, while controls comprised 214 patients (including patients with hemolysis and/or type 2 diabetes mellitus). HbA1c was expressed in International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) units (iA1c). GA/iA1c ratios, reticulocyte counts, EC, and MRBC in patients with latent hemolysis were compared to non-hemolysis, compensatory hemolysis, and hemolytic anemia patients. Both reticulocyte counts and haptoglobin levels were within reference ranges in patients with latent hemolysis. GA/iA1c ratios and EC were higher than reference values in patients with latent hemolysis, and MRBC values were 41.6 and 48.4 days, respectively, shorter than the reference range (49.1–66.8 days). EC measurement and MRBC values calculated on the basis of EC might be useful for diagnosing latent hemolysis.