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the type of CO-oximeter used for the initial analysis. However, from the tabulated data the reader is apt to conclude that the measurement was done on an IL 482 instrument (Instrumentation Laboratory, Milan, Italy). The IL 282 and IL 482 CO-oximeters have not been constructed for determination of sulfhemoglobin. Nevertheless, these instruments can give a strong indication of the presence of sulfhemoglobin in a blood sample on the basis of a combined positive result for methemoglobin and a negative value for carboxyhemoglobin. This bizarre phenomenon was first observed by Zwart et al. and published in an evaluation report of the IL 282 CO-oximeter in 1981 [2]. In the IL 282 and IL 482 operator’s manuals, it is mentioned that these instruments were not constructed for the determination of sulfhemoglobin and that sulfhemoglobin may interfere with the determination of methemoglobin. The wording of the statement, however, may be unclear: “The spectral absorbance of sulfhemoglobin is similar to that of methemoglobin and the same limitations would apply. Sulfhemoglobin is not commonly found in blood, however, making such interference rare.” We would favor wording such as: “The spectral absorbance of sulfhemoglobin is similar to that of methemoglobin. Therefore, the presence of sulfhemoglobin in a blood sample will cause a positive interference or false-positive result for methemoglobin. The presence of sulfhemoglobin in a blood sample is suspected whenever a methemoglobin result is displayed $10%, combined with a negative carboxyhemoglobin value.” IL now markets the model 682 CO-oximeter, which will detect and actually indicate sulfhemoglobin concentrations .1.5%, making this clarification in the new instrument’s manual unnecessary. However, manufacturers could help users if they clearly mention all known clinically relevant limitations in instrument manuals and update the manuals with all essential information published in the scientific literature. References 1. Zoppi F, Brenna S, Fumagalli C, Marocchi A. Discrimination among dyshemoglobins: analytical approach to a toxicological query. Clin Chem 1996;42:1300–2.

Hair Iron Content: Possible Marker to Complement Monitoring Therapy of Iron Deficiency in Patients with Chronic Inflammatory Bowel Disease?