Discriminant indexes to simplify the differential diagnosis between iron deficiency anemia and thalassemia minor in individuals with microcytic anemia

Abstract

SUMMARY INTRODUCTION: Microcytic anemias are very common in clinical practice, with iron deficiency anemia (IDA) and thalassemia minor (TT) being the most prevalent. Diagnostic confirmation of these clinical entities requires tests involving iron metabolism profile, hemoglobin electrophoresis, and molecular analysis. In this context, several discriminant indices have been proposed to simplify the differential diagnosis between IDA and TM. OBJECTIVE: The aim of this paper was to demonstrate the clinical relevance of the use of discriminant indices in individuals with microcytic anemia to simplify the differential diagnosis between iron deficiency anemia and minor thalassemia. METHODS: A bibliographic and cross-sectional search was performed in the PubMed, SciELO and LILACS databases, using the following descriptors: iron deficiency anemia, thalassemia minor, and differential diagnosis. RESULTS: More than 40 mathematical indices based on erythrocyte parameters have been proposed in the hematological literature in individuals with microcytosis. Green & King indexes (IGK), Ehsani index, and erythrocyte count (RBC) had excellent performances, especially when their efficacy was observed in adults and children. CONCLUSIONS: Confirmatory tests for differential diagnosis between IDA and TM require time-consuming and costly methods. Despite the excellent performances of IGK, Ehsani index, and RBC, none of them presented sufficient sensitivity and specificity to establish a diagnosis. However, they can provide a powerful additional tool for diagnostic simplification between IDA and TM.

Anaemia Among Children Who Attended the Children’s Teaching Hospital in Karbala, Iraq

“… 29 However, a review article showed that despite the excellent performances of the Green and King index (IGK), the Ehsani index, and RBC count, none of them presented sufficient sensitivity and specificity to establish a diagnosis between thalassemia and IDA, and these tests require more time-consuming and costly methods. 30 As mentioned earlier, there is a limitation in studies that investigate the prevalence of anaemia in Iraq; to the best of our knowledge, this is the first study to investigate this aspect among children in Karbala, Iraq. Our findings showed that the prevalence of anaemia among children aged 0–14 years in Karbala was 9.9%, which is considered high.…”

Prevalence and Clinical Features of Thalassemia Minor Cases

“…North Waziristan has been divided into three subdivisions. Participants Criteria: All the confirmed thalassemia minor patients was included in this study confirmed by Hb electrophoresis and other then thalassemia minor was excluded 21 . Data Collection Procedure: To collect information from Thalassemia minor patients, a questionnaire was designed, pretested and finalized before the actual survey was conducted.…”