Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices

Jameel, Tahir Ahmed; Baig, Mukhtiar; Ahmed, Ijaz; Hussain, Muhammad Barakat; Alkhamaly, Motlag bin Doghaim

doi:10.12669/pjms.333.12098

Cited by 40 publications

(46 citation statements)

References 18 publications

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“…The RDWI had high YI (81.6%). These results are consistent with the findings of other relevant studies who found that the highest YI was obtained for RDWI 69.2%, 83% and 73.8% respectively[23] [24]…”

supporting

confidence: 93%

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Hamed¹,

El-Deen²

2019

OJBD

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Background: The most common causes of microcytic hypochromic anemia are iron deficiency anemia (IDA) and the beta-thalassemia trait (β-TT). The aim of the work is to compare the validity of the various simple indices to differentiate between iron deficiency anemia and β-thalassemia trait. Subjects and methods: A total of 2000 individuals were screened, by complete blood picture, measurement of serum iron, serum ferritin and hemoglobin separation; 224 patients were detected as having hypochromia and microcytosis.Among them 166 cases were IDA and 58 cases were β-TT. We calculated 11 discrimination indices. The number of correctly identified cases were determined, sensitivity, specificity, positive and negative predictive value and Youden's index (YI) of each discrimination index was calculated. Results: The percentage of correctly diagnosed patients is highest for Matos and Carvalho index (MCI) (95.5%) which is closely followed by Red cell distribution width index (RDWI) (93.7%). The third high index was Green and King (GKI) (91.9%). Sensitivity, specificity of MCI for detection of IDA was found 98.8%, 87.9% respectively. For β-TT, sensitivity and specificity was found 86.2% and 98.8% respectively. The YI of MCI was found 85.9%. It is followed by RDWI; its sensitivity and specificity for detection of IDA was found 97.6%, 85.3%. For β-TT, sensitivity and specificity was found 82.7% and 97.6% respectively. The YI of RDWI was 81.6%. Conclusion: Matos and Carvalho index and RDWI are easily available automated cell-count-based indices coming out as good discriminator between IDA and β-TT in our study.

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supporting

confidence: 93%

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Hamed¹,

El-Deen²

2019

OJBD

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“…Another interesting finding was the tendency of red cell volume distribution width (RDW) elevation proportionally to the loss of the alpha genes, corroborating with other studies in the literature. e thalassemia patients have smaller and more homogeneous erythrocytes (mainly microcytic), which leads us to correlate high RDW in iron deficiency than in thalassemia [34][35][36].…”

Section: Resultsmentioning

confidence: 99%

Deletional Alpha-Thalassemia Alleles in Amazon Blood Donors

Anselmo

Ferreira

Mota

et al. 2020

Advances in Hematology

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Alpha-thalassemia is highly prevalent in the plural society of Brazil and is a public health problem. There is limited knowledge on its accurate frequency and distribution in the Amazon region. Knowing the frequency of thalassemia and the prevalence of responsible mutations is, therefore, an important step in the understanding and control program. Hematological and molecular data, in addition to serum iron and serum ferritin, from 989 unrelated first-time blood donors from Amazonas Hemotherapy and Hematology Foundation (FHEMOAM) were collected. In this study, the subjects were screened for −α3.7/4.2/20.5, −SEA, −FIL, and −MED deletions. Alpha-thalassemia screening was carried out between 2016 and 2017 among 714 (72.1%) male and 275 (27.9%) female donors. The aims of this analysis were to describe the distribution of various alpha-thalassemia alleles by gender, along with their genotypic interactions, and to illustrate the hematological changes associated with each phenotype. Amongst the patients, 5.35% (n = 53) were diagnosed with deletion –α−3.7 and only one donor with α−4.2 deletion. From the individuals with –α−3.7, 85.8% (n = 46) were heterozygous and 14.20% (n = 7) were homozygous. The frequency of the –α−3.7 deletion was higher in male (5.89%) than in female (4.0%). There is no significant difference in the distribution of –α−3.7 by gender (p=0.217). The –α20.5, −SEA, and −MED deletions were not found. All subjects were analyzed for serum iron and serum ferritin, with 1.04% being iron deficient (n = 5) and none with very high levels of stored iron (>220 µg/dL). Alpha-thalassemia-23.7kb deletion was the most common allele detected in Manaus blood donors, which is a consistent result, once it is the most common type of α-thalassemia found throughout the world. As expected, the mean of hematological data was significantly lower in alpha-thalassemia carriers (p<0.001), mainly homozygous genotype. Leukocytes and platelet count did not differ significantly. Due to the small number of individuals with iron deficiency found among blood donors, the differential diagnosis between the two types of anemia was not possible, even because minor changes were found among hematological parameters with iron deficiency and α-thalassemia. Despite this, the study showed the values of hematological parameters, especially MCV and MCH, are lower in donors with iron deficiency, especially when associated with α-thalassemia, and therefore, it may be useful to discriminate different types of microcytic anaemia. In conclusion, we believed screening for thalassemia trait should be included as part of a standard blood testing before blood donation. It should be noted that this was the first study to perform the screening for alpha deletions in blood donors from the Manaus region, and further studies are required to look at the effects of donated thalassemic blood.

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“…In India, on an average estimate 8000-1000 children are born every year with thalassemia major disease [10]. Several studies in the literature have reported that Sindhi community has high frequency of thalassemia along with similarity in clinical features of iron deficiency and traits of β thalassemia [7,11]. In the present study, traits of β thalasemia and iron deficiency anemia cases were confirmed by HbA2 levels and serum ferritin levels with the study of red cell indices MCV, MCH, RBC count and RDW.…”

Section: Discussionmentioning

confidence: 99%

“…Pathology Update: Tropical Journal of Pathology & Microbiology Available online at: www.medresearch.in 450 | P a g e and reduce unnecessary cost [7][8][9]. Long term objective of this study was screening of anemic individuals of Sindhi community for thalassemia trait and to reduce the disease burden and preventing the inheritance by proper counseling and awareness also at lower cost and even in small set ups.…”

Section: Original Research Articlementioning

confidence: 99%

Hematological study of iron deficiency anemia and β thalassemia trait in Sindhi community of Bundelkhand region of Madhya Pradesh with predictive value of red cell indices to discriminate them

Gangwani

Shah

2019

Trop J Pathol Microbiol

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Background: Ethnic groups like Sindhis, Kutchis, Lohanas, Punjabis, few Muslim groups as well as few tribal populations have higher prevalence of hemoglobinopathy esespecially β thalassemia carriers. β Thalassemia traits are commonly misdiagnosed as iron deficiency anemia. Red cell indices are helpful to discriminate anemia and to detect subjects who have high probability of requiring appropriate follow up and to reduce unnecessary investigation cost. Aims and objectives: 1) To study red blood cell indices in all cases of microcytic hypochromic anemia. 2) Estimation of HbA2 levels and serum ferritin levels to confirmiron deficiency anemia and β thalassemia trait. 3) To evaluate the diagnostic values of various red cell indices in discriminating iron deficiency anemia and β thalassemia trait. Materials and methods: It is a prospective observation study carried out on Sindhi individuals of Sagar District of Bundelkhand region of Madhya Pradesh. Hemoglobin, RBC count, MCV, MCH and RDW were determined. Serum ferritin levels and HbA2 levels were detected. Result: Out of total 200 cases of Sindhi individuals 25 patients (12.5%) were grouped in β thalassemia trait while 175 patients (87.5%) were grouped in iron deficiency anemia group on the basis of HbA2 and serum ferritin level. Significant difference was found inmean MCV, MCH, RDW and RBC count and showed high sensitivity and specificity to discriminate iron deficiency anemia from β thalassemia. Conclusion: Sindhi community of Sagar district of Madhya Pradesh showed high prevalence of β thalassemia trait. Mass awareness and proper pre marriage genetic counseling and prenatal diagnosis should be done to reduce the burden of disease.

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Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices

Cited by 40 publications

References 18 publications

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Deletional Alpha-Thalassemia Alleles in Amazon Blood Donors

Hematological study of iron deficiency anemia and β thalassemia trait in Sindhi community of Bundelkhand region of Madhya Pradesh with predictive value of red cell indices to discriminate them

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