Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Abstract

Background: The most common causes of microcytic hypochromic anemia are iron deficiency anemia (IDA) and the beta-thalassemia trait (β-TT). The aim of the work is to compare the validity of the various simple indices to differentiate between iron deficiency anemia and β-thalassemia trait. Subjects and methods: A total of 2000 individuals were screened, by complete blood picture, measurement of serum iron, serum ferritin and hemoglobin separation; 224 patients were detected as having hypochromia and microcytosis.Among them 166 cases were IDA and 58 cases were β-TT. We calculated 11 discrimination indices. The number of correctly identified cases were determined, sensitivity, specificity, positive and negative predictive value and Youden's index (YI) of each discrimination index was calculated. Results: The percentage of correctly diagnosed patients is highest for Matos and Carvalho index (MCI) (95.5%) which is closely followed by Red cell distribution width index (RDWI) (93.7%). The third high index was Green and King (GKI) (91.9%). Sensitivity, specificity of MCI for detection of IDA was found 98.8%, 87.9% respectively. For β-TT, sensitivity and specificity was found 86.2% and 98.8% respectively. The YI of MCI was found 85.9%. It is followed by RDWI; its sensitivity and specificity for detection of IDA was found 97.6%, 85.3%. For β-TT, sensitivity and specificity was found 82.7% and 97.6% respectively. The YI of RDWI was 81.6%. Conclusion: Matos and Carvalho index and RDWI are easily available automated cell-count-based indices coming out as good discriminator between IDA and β-TT in our study.

Differentinating between non-transfusion dependant β-thalassemia and iron deficinecy anemia in children using ROC and logistic regression analysis: two novel discrimination indices designed for pediatric patients

“…Due to Croatia's association with the Mediterranean population, high accuracy of the Matos-Carvalho index is expected. A similar performance of the Matos-Carvalho index was observed in the adult Egyptian population ( 19 ). This index has not been previously tested in children.…”

“…After defining the optimal cut-off value, the CRUISE index outperformed the formulas/indices initially developed for the adult Iranian population ( 29 ). Hameed index with the new cut-off value showed balanced sensitivity and specificity with acceptable accuracy ( 19 ). After defining the optimal cut-off value, the Sargolzaie index also significantly increased its accuracy ( 30 ).…”

Clinical utility of Abbott Alinity hq extended red blood cell parameters in differentiating β‐thalassemia trait and iron deficiency anemia

“…31 The England and Fraser index was the best discriminating mathematical formula in our patient population, and the Ricerca, RDWI, Green and King, and Mentzner index formulas also showed strong discriminative power, in agreement with the results of many studies. 32,33 On the other hand, the Shine and Lal index was identified as a moderate discriminator only (Sensitivity = 83.0% and Specificity = 74.4%). This formula has shown variable performance in the literature.…”