Reliability of red blood cell indices and formulas to discriminate between<i>β</i>thalassemia trait and iron deficiency in children

Background. The two most frequent types of microcytic anemia are beta thalassemia trait (β-TT) and iron deficiency anemia (IDA). We retrospectively evaluated the reliability of various indices for differential diagnosis of microcytosis and β-TT in the same patient groups. Methods. A total of 290 carefully selected children aged 1.1–16 years were evaluated. We calculated 12 discrimination indices in all patients with hemoglobin (Hb) values of 8.7–11.4 g/dL. None of the subjects had a combined case of IDA and β-TT. All children with IDA received oral iron for 16 weeks, and HbA2 screening was performed after iron therapy. The patient groups were evaluated according to red blood cell (RBC) count; red blood distribution width index; the Mentzer, Shine and Lal, England and Fraser, Srivastava and Bevington, Green and King, Ricerca, Sirdah, and Ehsani indices; mean density of hemoglobin/liter of blood; and mean cell density of hemoglobin. Results. The Mentzer index was the most reliable index, as it had the highest sensitivity (98.7%), specificity (82.3%), and Youden's index (81%) for detecting β-TT; this was followed by the Ehsani index (94.8%, 73.5%, and 68.3%, resp.) and RBC count (94.8%, 70.5%, and 65.3%). Conclusion. The Mentzer index provided the highest reliabilities for differentiating β-TT from IDA.

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“…), and that the Green and King index had the highest efficiency (80.2%) in 458 children with mild microcytic anemia aged 1.8–7.5 years [17]. …”

Section: Discussionmentioning

confidence: 99%

Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia

Vehapoğlu

Özgürhan

Demir

et al. 2014

Anemia

102

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“…The blood picture and the study of hematological parameters are the key to decide further course of investigation. Many discriminatory indices are available to differentiate β thalassemia trait from iron deficiency anemia (IDA)[10–12] but no index is described to differentiate clearly between different types of thalassemias itself on the basis of hematological findings. The studies carried out to discriminate between various types of thalassemias on the basis of hematological findings and especially on red cell indices are very limited.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of hematological parameters of α and β thalassemias in a high prevalence zone: Saudi Arabia

Mehdi

Dahmash

2011

Indian J Hum Genet

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BACKGROUND AND AIMS:Saudi Arabia falls in the high prevalent zone of αα and β thalassemias. Early screening for the type of thalassemia is essential for further investigations and management. The study was carried out to differentiate the type of thalassemia based on red cell indices and other hematological parameters.MATERIALS AND METHODS:The study was carried out on 991 clinically suspected cases of thalassemias in Riyadh, Saudi Arabia. The hematological parameters were studied on Coulter STKS. Cellulose acetate hemoglobin electrophoresis and high-performance liquid chromatography (HPLC) were performed on all the blood samples. Gene deletion studies were carried out by restriction fragment length polymorphism (RFLP) technique using the restriction endonucleases Bam HI.STATISTICAL ANALYSIS:Statistical analysis was performed on SPSS 11.5 version.RESULTS:The hemoglobin electrophoresis and gene studies revealed that there were 406 (40.96%) and 59 (5.95 %) cases of β thalassemia trait and β thalassemia major respectively including adults and children. 426 cases of various deletion forms of α thalassemias were seen. Microcytosis was a common feature in β thalassemias trait and (-α/-α) and (--/αα) types of α thalassemias. MCH was a more significant distinguishing feature among thalassemias. β thalassemia major and α thalassemia (-α/αα) had almost normal hematological parameters.CONCLUSION:MCV and RBC counts are not statistically significant features for discriminating between α and β thalassemias. There is need for development of a discrimination index to differentiate between α and β thalassemias traits on the lines of discriminatory Indices available for distinguishing β thalassemias trait from iron deficiency anemia.

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“…RDW is a measure of the range of variation of red blood cell volume that is readily available from complete blood count results. RDW increase is seen in anisocytosis in which RBCs are not equal in size (10). This increase was shown to be in relationship between smoking which is explained by some pathophysiological mechanisms.…”

Section: Discussionmentioning

confidence: 88%

Do we care enough about the role of smoking in the etiology of polycythemia?

Öcal¹,

Arslan²,

Ozgur³

et al. 2019

Gulhane Med J

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In this study, we aimed to determine the hematopoietic effects of tobacco use and amount of usage, and to determine its possible relationships with secondary polycythemia in patients without active pulmonary pathology. Methods Patients who were diagnosed with polycythemia in the Hematology Department and referred to the Chest Diseases Department for the purpose of investigating possible secondary polycythemia etiologies during the last one year were reviewed retrospectively. The ethical approval number is 18/182. Data

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Reliability of red blood cell indices and formulas to discriminate betweenβthalassemia trait and iron deficiency in children

Cited by 34 publications

References 11 publications

Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia

Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia

A comparative study of hematological parameters of α and β thalassemias in a high prevalence zone: Saudi Arabia

Do we care enough about the role of smoking in the etiology of polycythemia?

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