Indices Used in Differentiation of Thalassemia Trait from Iron Deficiency Anemia in Pediatric Population: Are They Reliable?

Nalbantoğlu, Burçin; Güzel, Savaş; Büyükyalçın, Volkan; Donma, Mustafa Metın; Güzel, Eda Çelik; Nalbantoğlu, Ayşin; Karasu, Erkut; Ozdilek, Burcu

doi:10.3109/08880018.2012.705230

Cited by 29 publications

(28 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Different red cell indices and formulas have been proposed as simple and inexpensive tools for initial discrimination of b-thal trait from iron deficiency (8,9,12,16). In the present study, we evaluated the diagnostic reliability of the different red cell indices and formulas for discrimination of b-thal trait from iron deficiency in adult Thai subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, blood features of thalassemia and iron deficiency are similar. Thus, there are many studies reporting the diagnostic reliability of different red cell indices and formulas used in discrimination of b-thal trait from iron deficiency (8)(9)(10)(11)(12). However, the screening reliability of these indexes is controversial and differ from one country to another (8,9,12).…”

Section: Introductionmentioning

confidence: 98%

“…Thus, there are many studies reporting the diagnostic reliability of different red cell indices and formulas used in discrimination of b-thal trait from iron deficiency (8)(9)(10)(11)(12). However, the screening reliability of these indexes is controversial and differ from one country to another (8,9,12). The inter-population differences in effectiveness of red cell indices and formulas in discrimination of b-thal trait from iron deficiency might be due to the differences of molecular spectrum of the b-thal disorders in various countries, the degree of anemia in iron deficient subjects, sample size, and mean age of subjects.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Red Cell Indices and Formulas Used in Differentiation ofβ-Thalassemia Trait from Iron Deficiency in Thai Adults

et al. 2015

View full text Add to dashboard Cite

β-Thalassemia (β-thal) and iron deficiency cause most microcytic anemias. Red cell indices and formulas have been established as simple, fast, and inexpensive in discrimination between these two hematological disorders in school children. However, whether these formulas could be applied to diagnose β-thal trait and iron deficiency in adult Thai subjects is unclear. The aim of this study was to examine the diagnostic accuracy of five red cell indices [red blood cell (RBC) counts, mean corpuscular volume (MCV), mean corpuscular hemoglobin (Hb) (MCH), mean corpuscular Hb concentration (MCHC), and red cell distribution width (RDW)] and nine formulas (RDW/RBC, RDW Index, Sirdah, Green and King, Mentzer, England and Fraser, Ehsani, Srivastava and Shine and Lal). Their sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), efficiency, and Youden's Index were analyzed in 102 β-thal trait and 64 iron deficiency adult Thai subjects. The RDW/RBC formula proved to be the most reliable index as they had 100.0% specificity and PPV and the highest efficiency (94.58%) and Youden's Index (91.18%), as well as high sensitivity (91.18%) and NPV (87.67%). Therefore, this formula could be used in initial discrimination of β-thal trait from iron deficiency in adult Thai subjects.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Red Cell Indices and Formulas Used in Differentiation ofβ-Thalassemia Trait from Iron Deficiency in Thai Adults

et al. 2015

View full text Add to dashboard Cite

show abstract

“…

We read with interest the article by Nalbantoglu et al [1]. In their article, it was stated that the valid formulas calculated from erythrocyte indices on automated blood counts are not sufficient to discriminate between thalassemia minor (TM) and iron deficiency (ID) in pediatric patients.

…”

mentioning

confidence: 96%

Use of Serum Iron Status and Hemoglobin A2 Levels for Discrimination Between Iron Deficiency and Thalassemia Minor

Aslan

2013

Pediatric Hematology and Oncology

View full text Add to dashboard Cite

We read with interest the article by Nalbantoglu et al. [1]. In their article, it was stated that the valid formulas calculated from erythrocyte indices on automated blood counts are not sufficient to discriminate between thalassemia minor (TM) and iron deficiency (ID) in pediatric patients. It is also reported that the most reliable discrimination between these two entities might be done using the parameters of body iron status (serum iron↓, serum iron binding capacity↑, and serum ferritin↓) and hemoglobin A2 (HbA2↑) level. These tests, if available, were suggested for achieving a definite diagnosis in every case with microcytosis. Based on our experience [2-6], we do agree with the authors' opinion regarding the incapability of the formulas to discriminate between these two entities. However, we would like to emphasize that the parameters suggested by the authors might also prove insufficient in some particular situations. With this letter, we want to point out those particular clinical conditions. These conditions should be taken into consideration in discriminating between TM and ID. NORMAL A2 BETA-THALASSEMIAIn these patients without an altered HbA2 level, thalassemia may be overlooked [7]. However, normal body iron status in the patient with microcytosis should alert the clinician to the presence of thalassemia, and the next step should be parental study. Presence of a similar situation in at least one parent would indicate thalassemia. DELTA-BETA-THALASSEMIAPatients with delta-beta-thalassemia have normal body iron status and low HbA2 levels [7]. In addition, red cell distribution width (RDW) value is abnormally wide [2], suggesting the possibility of ID. Family studies are necessary. Presence of similar results in at least one parent would indicate delta-beta-thalassemia.

show abstract

“…Iron deficiency anemia is usually caused by a broad spectrum of reasons such as malnutrition and is largely detected based on hematological laboratory findings [5]. Many discriminating indices in the distinction between IDA and thalassemia trait (TT) have been introduced using RBC indices so far [6,7], which we have been reported the accuracy and clinical application of those indices, previously [8,9]. Though these indices reported that were widely used in clinical decision-making and has several advantages, but the reliability of such indices is questionable and controversial [10].…”

Section: Introductionmentioning

confidence: 99%

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Rahim¹

2017

Russ. Open Med. J.

View full text Add to dashboard Cite

Abstract:Purpose -We performed a meta-analysis of all eligible case-control studies published to date, to assess the association of salivary ferritin and iron with hematological disorders. Methods -We conducted Medline/PubMed and Scopus searches for papers published from January 1, 1980, through January 1, 2013. Data were merged the summary mean difference were estimated using either a random-effects model or a fixed-effects model. Results -There were 3 studies including 196 cases and 70 controls. There was a statistically significant difference in the salivary ferritin and iron between hematological diseases and control groups, and the summary estimate of mean difference was 1.37 (95%CI: 0.01-2.74) and 2.23 (0.92-3.54) in salivary ferritin and iron, respectively. The stratification showed the same statistically significant differences in the salivary ferritin between Iron deficiency anemia (IDA) with thalassemia intermedia (TI), and IDA with thalassemia major (TM) groups. Besides, the stratification showed that there were statistically significant differences in the salivary iron between IDA with TM groups, while no statistically significant difference was observed between IDA with TI. Conclusion -Saliva ferritin iron and ferritin increase significantly in patients with thalassemia compared to IDA. Salivary ferritin and iron can be used as a diagnostic marker and new discriminating indices routinely to differentiate IDA from thalassemia, especially thalassemia trait; furthermore, their easy applicability, safe, relatively simple, and noninvasive procedure may be an important advantage compared to blood sample collection. Consequently, it could be promising to develop a simplified testing and differentiating procedure, which could reach many clinical decision-makers as a diagnostic potential.

show abstract

Indices Used in Differentiation of Thalassemia Trait from Iron Deficiency Anemia in Pediatric Population: Are They Reliable?

Abstract: In our study, none of the formulas appears reliable in discriminating between TT and IDA patients. The evaluation of iron status and measurement of hemoglobin A(2) (HbA(2)) remain the most reliable investigations to differentiate between TT and IDA patients.

Cited by 29 publications

References 26 publications

Red Cell Indices and Formulas Used in Differentiation ofβ-Thalassemia Trait from Iron Deficiency in Thai Adults

Red Cell Indices and Formulas Used in Differentiation ofβ-Thalassemia Trait from Iron Deficiency in Thai Adults

Use of Serum Iron Status and Hemoglobin A2 Levels for Discrimination Between Iron Deficiency and Thalassemia Minor

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Contact Info

Product

Resources

About