A STRATEGY TO DETECT Β-Thalassæmia MINOR

Shine, Ian; Lal, Sardari

doi:10.1016/s0140-6736(77)92128-6

Cited by 143 publications

(99 citation statements)

References 9 publications

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“…Therefore, several simple screening indices have been developed for differentiating between thalassemia trait and IDA [2][3][4][5][6][7][8] and more recently these were supplemented with other supposedly better performing indices [9][10][11][12][13][14] (Table 1). It is widely agreed that none of these indices is 100% sensitive or 100% specific.…”

Section: Introductionmentioning

confidence: 99%

Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis

Hoffmann

Urrechaga

Aguirre

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: More than 40 mathematical indices have been proposed in the hematological literature for discriminating between iron deficiency anemia and thalassemia trait in subjects with microcytic red blood cells (RBCs). None of these discriminant indices is 100% sensitive and specific and also the ranking of the discriminant indices is not consistent. Therefore, we decided to conduct the first meta-analysis of the most frequently used discriminant indices. Methods: An extensive literature search yielded 99 articles dealing with 12 indices that were investigated five or more times. For each discriminant index we calculated the diagnostic odds ratio (DOR) and summary ROC analysis was done for comparing the performance of the indices. Results:The ratio of microcytic to hypochromic RBCs (M/H ratio) showed the best performance, DOR = 100.8. This was significantly higher than that of all other indices investigated. The RBC index scored second (DOR = 47.0), closely followed by the Sirdah index (DOR = 46.7) and the Ehsani index (DOR = 44.7). Subsequently, there was a group of four indices with intermediate and three with lower DOR. The lowest performance (DOR = 6.8) was found for the RDW (Bessman index). Overall, the indices performed better for adults than for children.

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Section: Introductionmentioning

confidence: 99%

Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis

Hoffmann

Urrechaga

Aguirre

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…On the other hand, typical thalassemia diognosis methods using red blood cell indices [5][6][7] belatedly reveal the disease because of changes in hemoglobin during fetal and postnatal periods 8,9 . Therefore, health system managers today prefer to employ preventive measures through different strategies, including pre-marriage screening of couples, genetic counselling, and informing at risk couples.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of fingerprint patterns: An explorative study on beta-thalassemia diagnosis

Solhi

Hashemieh

Nejad

et al. 2010

Bangladesh Med Res Counc Bull

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Rapid diagnosis of major β thalassemia along with certain preventive measures is of utmost significance. The present study aims to compare the fingerprints in Major β thalassemic patients (67) and in their parents (76 with minor thalassemia) with the normal fingerprints of control group (144). A forensic medical examiner determined fingerprint types of arch, loop, whorl and other types. Like normal individuals, loop fingerprint pattern was found to be the most common fingerprint type among thalassemic patients. However, the number of whorl fingerprints in all fingers in thalassemic patients was greater than that of normal individuals and the number of loop fingerprints was smaller (p<0.05). Arch type fingerprint pattern was less frequent in major thalassemic patients compared to minor thalassemic ones (p<0.05). The findings show that the number of whorl fingerprint patterns in thalassemic patients was greater than that of normal individuals, while the number of loop fingerprint patterns being smaller and the frequency of arch fingerprint pattern in patients with major thalassemia was lower than that of minor thalassemic patients. Therefore, one may choose fingerprint pattern as a simple, affordable and appropriate screening method to help detect the afflicted patients and prevent severe cases of thalassemia.

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“…The indices proposed by Ricerca et al (1987), Shine and Lal (1977) and Green and King (1989) worked reasonably well for detecting beta-thalassaemia traits and most except those proposed by Shine and Lal (1977) and Srivastava and Bevington (1973) were sensitive for detecting iron deficiency. Overall, the most accurate indices appeared to be those proposed by Green and King (1989) and Ricerca et al (1987).…”

Section: Resultsmentioning

confidence: 92%

Screening for the beta-thalassaemia trait: hazards among populations of West African Ancestry

et al. 2011

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The aim of this study was to examine the accuracy and characteristics of detecting the betathalassaemia trait in populations of West African ancestry. School children, aged 16-19 years, in Manchester Parish, Jamaica were screened to detect the genes which could give rise to offspring with sickle cell disease. Haematological indices and HbA 2 levels in subjects with an MCH≤26 pg and an RDW<18.0 with DNA analysis in those with indices consistent with the beta thalassaemia trait were measured. The performance of published discriminant indices in distinguishing iron deficiency and betathalassaemia trait in this population was assessed. Of 10,148 subjects, 1,739 (17.1%) had an AA haemoglobin phenotype and red cell indices consistent with betathalassaemia (MCH values≤26 pg, RDW<18.0) requiring estimations of HbA 2 levels. HbA 2 levels were ≥3.5% in 112 and beta-thalassaemia mutations were identified in 77 of these including the −88 C>T mutation in 35 (45%), −29 A>G in 19 (25%), −90 C>T in 7 (9%), the IVS II-849 A>G in 5 (6%) with smaller contributions from five other mutations. Discriminant indices performed poorly in the differentiation of iron deficiency and the beta-thalassaemia trait. Detection of the beta-thalassaemia trait is relatively insensitive in populations of West African ancestry partly because of the mild defects characterising beta-thalassaemia in this population and also the high prevalence of deletional alpha thalassaemia. More sensitive indicators are required for beta-thalassaemia detection to inform such populations at risk of offspring with sickle cell disease.

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A STRATEGY TO DETECT Β-Thalassæmia MINOR

Cited by 143 publications

References 9 publications

Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis

Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis

Diagnostic value of fingerprint patterns: An explorative study on beta-thalassemia diagnosis

Screening for the beta-thalassaemia trait: hazards among populations of West African Ancestry

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