Reliability of Different RBC Indices and Formulas in Discriminating Between Β-Thalassemia Minor and Other Causes of Microcytic Hypochromic Anemia

Bordbar, Elahe; Taghipour, Mehdi; Zucconi, Beth E.

doi:10.4084/mjhid.2015.022

Cited by 43 publications

(39 citation statements)

References 19 publications

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“…Unfortunately, the cost of the test is quite high and the test does not always available in routine practice. (3,15,17) This study involved 202 patients from many regions in Indonesia who underwent thalassemia screening and fulfilled the study's criteria. Most of the subjects were female (74.3%).…”

Section: Discussionmentioning

confidence: 99%

Early Screening of Hemoglobinopathy in Indonesia Using Erythrocyte Indices

et al. 2017

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BACKGROUND: The mutation spectrums of hemoglobinopathy are different among populations that yield a different result of erythrocyte indices. Calculation of erythrocyte indices with some formula has been reported to differentiate between hemoglobinopathy and non-hemoglobinopathy, but its cut-off should be recalculated specific for each population to gain a better sensitivity and specificity. We aimed to evaluate red blood cell count (RBC), Mentzer index, red cell distribution width (RDW), RDW index (RDWI), Shine and Lal index (S&L) and Green and King index (G&K) to screen hemoglobinopathy in Indonesia.METHODS: A retrospective cross-sectional study was performed on 202 subjects. The diagnosis of hemoglobinopathy was determined based on the results of complete blood count (CBC) data, high-performance liquid chromatography (HPLC) and Hemoglobin H (HbH) inclusion body. The ferritin concentration was checked to determine the status of iron. The erythrocytes indices were analyzed and calculated to predict hemoglobinopathy. RESULTS: A total 202 subjects who met the criteria were involved in this study. Fifty percent showed pure hemoglobinopathy and 4% showed a combination of thalassemia and hemoglobinopathy. The hemoglobin concentration and RBC were significantly higher, and the mean corpuscular volume (MCV) and RDW were significantly lower in hemoglobinopathy compared to iron deficiency. The difference was not significant if the hemoglobinopathy was combined with iron deficiency. By this study's cut-off, the G&K and RDWI showed the highest accuracy, sensitivity, and specificity.CONCLUSION: The new cut-off of erythrocyte index and its calculation to screen hemoglobinopathy in Indonesia showed a higher sensitivity and specificity, especially for G&K and RDWI with cut-off 73 and 228, respectively. The presence of iron deficiency in hemoglobinopathy could decrease the sensitivity.KEYWORDS: hemoglobinopathy, RBC, Mentzer index, RDW, RDWI, S&L, G&K

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Section: Discussionmentioning

confidence: 99%

Early Screening of Hemoglobinopathy in Indonesia Using Erythrocyte Indices

et al. 2017

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“…Ideally, one needs a battery of tests including detailed peripheral blood picture, Hb A 2 estimation, serumiron, TotalIron Binding Capacity (TIBC), serum ferritin and transferrin saturation to differentiate IDA from βTT clearly 9. But all these tests are either not available in all clinical set ups, or these are relatively time-consuming and expensive techniques.…”

Section: Introductionmentioning

confidence: 99%

“…But all these tests are either not available in all clinical set ups, or these are relatively time-consuming and expensive techniques. A number of studies have revealed that derived red cell indices including Red Cell Distribution Width (RDW) can be very helpful in differentiation of anisocytosis caused by IDA or βTT and a recently added Red Cell Distribution Width Index (RDWI) provide valuable help to the attending physician 7,9,10. RDWI is more advantageous as all the discriminating factors including RBC count, MCV and RDW are incorporated in its formula 11…”

Section: Introductionmentioning

confidence: 99%

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

Jameel¹,

Baig

Ahmed³

et al. 2017

Pak J Med Sci

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Objective:We aimed at finding out reliable parameter in the differentiation of iron deficiency anemia (IDA) and beta-thalassemia trait (β-TT) in the adult population subjected to Saudi Arabian Premarital Screening Program.Methods:A total of 620 adults (age range 21-36 years) reported during February 2012 to November 2012. Tests for serum iron and ferritin were carried out in individuals showing low hemoglobin (Hb). All the selected subjects’ samples were subjected to blood morphology, comparison of MCV, RBC count. Red Cell Distribution Width (RDW) was noted from the Coulter Report whereas Red Cell Distribution Width Index (RDWI) value was calculated for all the samples.Results:A total of one hundred &thirty-five individuals with hypochromic microcytic anemia having normal hemoglobin F and hemoglobin A2 < 3.2% were inducted in the study. Ninety-three were diagnosed having IDA, whereas thirty-two were having βTT. Ten individuals revealed other causes of anemia. The RBC count was higher, and MCV was much lower in βTT as compared to IDA. Both groups were subjected to RDW and RDWI, however, RDWI which showed better sensitivity and specificity for βTT.Conclusion:RDWI is a reliable and useful index for differentiation among IDA and βTT, as compared to RDW.

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“…A number of studies have revealed that derived red cell indices including red cell distribution width (RDW) can be very helpful in differentiation of anisocytosis caused by IDA or --TT and a recently added red cell distribution width index (RDWI) provide valuable help to the attending physician. (8)(9)(10) RDWI is more advantageous as all the discriminating factors including RBC count, MCV (mean corpuscular volume) and RDW are incorporated in its formula. (11) Derived indices like an index of RDW can be calculated using the automated blood cell counters for differentiation between IDA and -TT.…”

mentioning

confidence: 99%

New Indices for Differentiation Between Iron Deficiency Anemia and Beta Thalessemia Trait, a Study in Children.

Abdullah¹

2018

IJAR

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New indices, Iron deficiency anemia, Thalassemia trait. Background: The two most frequent types of microcytic hypochromic anemia in developing countries are beta thalassemia trait (-TT) and iron deficiency anemia (IDA). Several indices using blood cell count parameters have been suggested to differentiate between two. Aim of study: In this study, we compared the ability of different three indices (Mentzer index, RDWI and MCI) to distinguish-TT from IDA by calculating their sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden's index values. Methods: A total of 98 carefully selected children aged 1.0-17 years were evaluated. We calculated 3 discrimination indices in all patients with hemoglobin (Hb) values of 3.8-11.7 g/dL. None of the subjects had a combined case of IDA and-TT. The patient groups were evaluated according to red blood distribution width index; the Mentzer index and Matos and Carvalho index (MCI). Results: The Mentzer index was the most reliable index, as it had the highest sensitivity (96.06%), specificity (82.98%), and Youden's index (79.04%) for detecting-TT; this was followed by the RDW index (87.23%, 86.27%, and 73.5%, resp.) and MCI (91.49%, 80.04%, and 71.53%). Conclusion: The Mentzer index provided the highest reliabilities for differentiating-TT from IDA.

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Reliability of Different RBC Indices and Formulas in Discriminating Between Β-Thalassemia Minor and Other Causes of Microcytic Hypochromic Anemia

Cited by 43 publications

References 19 publications

Early Screening of Hemoglobinopathy in Indonesia Using Erythrocyte Indices

Early Screening of Hemoglobinopathy in Indonesia Using Erythrocyte Indices

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

New Indices for Differentiation Between Iron Deficiency Anemia and Beta Thalessemia Trait, a Study in Children.

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