Blood Rheological Characterization of β-Thalassemia Trait and Iron Deficiency Anemia Using Front Microrheometry

Abstract

The purpose of this work is to develop a hematocrit-independent method for the detection of beta-thalassemia trait (β-TT) and iron deficiency anemia (IDA), through the rheological characterization of whole blood samples from different donors. The results obtained herein are the basis for the development of a front microrheometry point-of-care device for the diagnosis and clinical follow-up of β-TT patients suffering hematological diseases and alterations in the morphology of the red blood cell (RBC). The viscosity is calculated as a function of the mean front velocity by detecting the sample fluid-air interface advancing through a microfluidic channel. Different viscosity curves are obtained for healthy donors, β-TT and IDA samples. A mathematical model is introduced to compare samples of distinct hematocrit, classifying the viscosity curve patterns with respect to the health condition of blood. The viscosity of the fluid at certain shear rate values varies depending on several RBC factors such as shape and size, hemoglobin (Hb) content, membrane rigidity and hematocrit concentration. Blood and plasma from healthy donors are used as reference. To validate their potential clinical value as a diagnostic tool, the viscosity results are compared to those obtained by the gold-standard method for RBC deformability evaluation, the Laser-Optical Rotational Red Cell Analyzer (LoRRCA).

Normalization of Blood Viscosity According to the Hematocrit and the Shear Rate

“…Diseases such as malaria [ 49 , 50 , 51 ], sickle cell anemia [ 52 , 53 ], diabetes [ 54 ], and hemolytic syndromes [ 55 , 56 , 57 ], which affect the biomechanical properties, have shown differences in the expected values of their blood viscosities as they flow at a fixed shear rate. These altered values of the viscosity are due to a decrease in the concentration of red blood cells, to an increase of the rigidity of the membrane of red blood cell, or to alterations in the aggregation process.…”

Logistic‐Nomogram model based on red blood cell parameters to differentiate thalassemia trait and iron deficiency anemia in southern region of Fujian Province, China

“…The differentiation between TT and IDA using simple, fast, and low economic cost technologies has been of high concern in recent years. For instance, a previous study suggests that the Mentzer index (MCV/RBC) is able to differentiate between patients with β‐TT and IDA with a sensitivity and specificity of 91% and 83%, respectively, in pregnant women 6 . Another study evaluated the capability of optical RBC technology for discriminating patients with β‐TT and IDA and revealed that the RBC concentration has the best discriminative value with an AUC of 0.963, followed by the RBC distribution width in the size distribution with an AUC of 0.960 and the RBC distribution width coefficient of variation with an AUC of 0.924 34 .…”

“…TT is a hereditary disease that is characterized by the aberrant synthesis of hemoglobin beta chain due to genetic abnormality, whereas IDA is characterized by the insufficiency of healthy red blood cells (RBCs) because of the lack of iron 2,3 . However, TT and IDA share some common clinical presentations, and it is challenging to differentiate between TT and IDA using regular laboratory examinations and the clinical symptoms of the patients 4–7 . Clinically, if IDA is misdiagnosed as TT, clinicians may neglect supplementation with iron and further investigate the real etiology.…”

Congenital Defects with Impaired Red Blood Cell Deformability – The Role of Next-Generation Ektacytometry

“…RBC deformability in thalassaemia is not well known. Recently, we have demonstrated that beta-thalassaemia (β-thal and δβ-thal) shows a characteristic left shift of osmoscan curve that is different from iron deficiency anaemia [77,78]. Probably, the decrease of one globin chain synthesis may lead to the imbalance of the α/β chains equilibrium and to the overproduction of the normal chain that may increase RBC dehydration and rigidity [8,78,79].…”