Quantitative measurement of red blood cell central pallor and hypochromasia

A quantitataive definition and techniques of measurement for central pallor of red blood cells are proposed. These are based on high-resolution measurements of absorbance across the center of the cell. Thus, the measurements reflect both variations in cell thickness and hemoglobin concentration. Although contributions of thickness and concentration may differ in individual cells, to a first approximation, a specific cell may be considered as having a similar concentration of hemoglobin throughout, and thus the major contribution to the central pallor is that due to the difference in thickness between the edges of the cell and the center. The definition proposed expresses central pallor as the percentage volume of indentation, comparing the red cell to a disc of uniform absorbance equal to the maximum found at the cell edges. Population distributions of central pallor then provide a basis for quantitation of hypochromasia. The mean and standard deviation of such distributions are proposed as quantitative descriptors. Sample distributions from 27 normal persons, 8 patients with spherocytic anemia and 26 patients with iron deficiency anemia were studied.