Erythropoietin Levels and Microcytosis in Heterozygous Beta-Thalassaemia

Abstract

Erythropoietin levels were determined in 50 Greek females: 20 beta-thalas-saemia (beta-thai) heterozygotes, 15 with a diagnosis of iron-deficiency anaemia and 15 normal controls. In beta-thai trait carriers, the erythropoietin levels were slightly higher than in normal controls (16.65 ± 4.43 vs. 12.84 ± 2.47 mU/ml); these levels were significantly lower than those in iron-deficient subjects with the same degree of anaemia (55.24 ± 31.35 mU/ml). In both groups, the erythropoietin levels are statistically correlated with the severity of anaemia (r = -0.537 p < 0.05 for iron deficiency; r = -0.610 p < 0.01 for beta-thai heterozygotes). In beta-thai heterozygotes, a close inverse correlation with red cell number and erythropoietin levels was also noted. It is suggested that microcytosis accompanying beta-thai trait constitutes an additional factor intervening in the regulation of erythropoiesis.

Hepcidin is suppressed by erythropoiesis in hemoglobin E β-thalassemia and β-thalassemia trait

“…38 Our data show that b-thalassemia carriers have suppressed hepcidin concentrations overall and out of proportion to their iron stores. Hepcidin concentrations predict iron absorption and use, 39 and thus, even moderate suppression of hepcidin, as seen here, can enhance iron absorption.…”

“…The plausible explanation is that the mild anemia and increase in Epo and erythropoiesis seen in this condition mediate hepcidin suppression. Epo levels are approximately 30% higher than controls in b-thalassemia trait, 38 which likely reflects the 20% reduction in hepcidin levels in this group. A recent study did not find decreased hepcidin in Brazilian b-thalassemia carriers, 40 but the 20 individuals investigated were patients attending a hemoglobinopathy clinic, and so may not represent the manifestation of b-thalassemia in the general population.…”

A Multicentre Based Observation of a Screening tool to Differentiate Microcytosis and Hypochromia

“…M/H ratio = % of Microcytosis / % of Hypochromia [12][13]15 . while mean % hypochromic demonstrated an opposite trend (thalassaemia 3.4%, IDA 20.4%; p-0.001) with Advia.…”

“…On the other hand, mean M/H ratio was higher in thalassaemia (15.1) than IDA (4.6; p-0.001). Here, the hypochromic red cells, measured by the Advia 2120 analyzer, defined by their Hb concentration 13,15 . In iron deficient erythropoiesis, synthesis of haemoglobin molecules are severely impaired leading to the production of RBC with low haemoglobin concentration19.…”

“…Quality control was also performed within assay and between assays running of controls. The sensitivity, predictive value and diagnostic accuracy of M/H ratio for Beta-thalassaemia trait was calculated according to the method of Galen and Gambino [1][2][3][10][11][12][13][14][15][16][17] .…”