Comparison of red cell distribution width and a red cell discriminant function incorporating volume dispersion for distinguishing iron deficiency from beta thalassemia trait in patients with microcytosis

Lima, Carmen Sílvia Passos; Reis, Aparecida Ribeiro de Carvalho; Grotto, Helena Zerlotti Wolf; Saad, Sara T.O.; Costa, Fernando Ferreira

doi:10.1590/s1516-31801996000500005

Cited by 25 publications

(16 citation statements)

References 11 publications

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“…O uso de índices hematimétricos para racionalizar a abordagem diagnóstica tem sido proposto para contornar essa problemática. Entretanto, seu emprego tem sido melhor documentado em estudos retrospectivos, com grupos de anemia ferropriva e beta-talassemia menor 3,4,5,6 .…”

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Uso de índices hematimétricos no diagnóstico diferencial de anemias microcíticas: uma abordagem a ser adotada?

Melo¹,

Purini²,

Cançado³

et al. 2002

Rev. Assoc. Med. Bras.

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Uso de índices hematimétricos no diagnóstico diferencial de anemias microcíticas: uma abordagem a ser adotada?

Melo¹,

Purini²,

Cançado³

et al. 2002

Rev. Assoc. Med. Bras.

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“…Many types of researche have been used these discriminating indices and reported various controversial results [36][37][38][39][40][41]. Given the availability of hemoglobin electrophoresis, these indices are not very imperative currently.…”

Section: Discussionmentioning

confidence: 99%

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Rahim¹

2017

Russ. Open Med. J.

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Abstract:Purpose -We performed a meta-analysis of all eligible case-control studies published to date, to assess the association of salivary ferritin and iron with hematological disorders. Methods -We conducted Medline/PubMed and Scopus searches for papers published from January 1, 1980, through January 1, 2013. Data were merged the summary mean difference were estimated using either a random-effects model or a fixed-effects model. Results -There were 3 studies including 196 cases and 70 controls. There was a statistically significant difference in the salivary ferritin and iron between hematological diseases and control groups, and the summary estimate of mean difference was 1.37 (95%CI: 0.01-2.74) and 2.23 (0.92-3.54) in salivary ferritin and iron, respectively. The stratification showed the same statistically significant differences in the salivary ferritin between Iron deficiency anemia (IDA) with thalassemia intermedia (TI), and IDA with thalassemia major (TM) groups. Besides, the stratification showed that there were statistically significant differences in the salivary iron between IDA with TM groups, while no statistically significant difference was observed between IDA with TI. Conclusion -Saliva ferritin iron and ferritin increase significantly in patients with thalassemia compared to IDA. Salivary ferritin and iron can be used as a diagnostic marker and new discriminating indices routinely to differentiate IDA from thalassemia, especially thalassemia trait; furthermore, their easy applicability, safe, relatively simple, and noninvasive procedure may be an important advantage compared to blood sample collection. Consequently, it could be promising to develop a simplified testing and differentiating procedure, which could reach many clinical decision-makers as a diagnostic potential.

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“…However, the identification of anisocytosis may be useful because "pure" thalassemia traits usually lead to a production of erythrocytes with lower size variation than does the iron deficiency [25,[37][38][39]. In this sense, if we considered all of the diagnosed microcytic-hypochromic cases that were accompanied by normal values of RDW in our study, we could infer that one third of the women with this erythrocyte morphology pattern could not have severe iron deficiency at the time of the evaluation.…”

Section: Discussionmentioning

confidence: 99%

Anemia among pregnant women attending primary healthcare units in the municipality of São Paulo, Brazil: evaluations after the mandatory fortification of wheat and maize flours with iron

Machado¹,

Carli²,

Szarfarc³

et al. 2016

Nutrire

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Background: Improvements in the iron status of a population as result of food fortification are expected at the long term. In Brazil, the effectiveness of mandatory flour fortification with iron has been evidenced mostly from surveys on gestational anemia after 1 or 2 years from its implementation, in 2004. Our aim was to assess hemoglobin (Hb) concentrations and the prevalences of anemia and linked erythrocyte morphology patterns among pregnant women in 2006 and 2008. Methods: The study design was retrospective and cross-sectional. The analysis was based on secondary data in 546 medical records from women at the times of their first prenatal attendance in 13 public primary healthcare units of the Butantan Administrative Region from São Paulo (SP), Brazil. Anemia was evaluated from Hb concentration (cut-off <11.0 g/dL) and erythrocyte morphology patterns from mean corpuscular volume (MCV), mean corpuscular Hb concentration (MHC), and red cell distribution widths (RDW). Recorded sociodemographic and obstetric data included maternal age, gestational age, ethnoracial self-classification, and residence type. Student's t tests, analysis of variance, Chi-squared tests, and multiple linear and logistic regressions were employed in the statistical analysis using a significance level of 5 %. Results: The prevalence of anemia was 9.7 % in 2006 and 9.4 % in 2008 (P = 0.922), with no significant difference in mean Hb concentrations (P = 0.159). Normocytosis (normal MVC), normochromia (normal MHC), and anisocytosis (high RDW) were found in most anemia cases, suggesting that the low Hb concentrations resulted from mixed causes. In multiple regression analysis, gestational age at the first prenatal attendance was an independent predictor of low Hb and of having anemia. Moreover, black ethnoracial self-classification was associated with lower Hb.

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Comparison of red cell distribution width and a red cell discriminant function incorporating volume dispersion for distinguishing iron deficiency from beta thalassemia trait in patients with microcytosis

Cited by 25 publications

References 11 publications

Uso de índices hematimétricos no diagnóstico diferencial de anemias microcíticas: uma abordagem a ser adotada?

Uso de índices hematimétricos no diagnóstico diferencial de anemias microcíticas: uma abordagem a ser adotada?

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Anemia among pregnant women attending primary healthcare units in the municipality of São Paulo, Brazil: evaluations after the mandatory fortification of wheat and maize flours with iron

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