The compatibility measurement of Mentzer, England &amp; Fraser, Shine &amp; Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening

Harahap, Raja Iqbal Mulya; Prihatni, Delita; Rostini, Tiene

doi:10.15562/bmj.v8i2.1457

Cited by 3 publications

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“…(9)The diagnosis of IDA is confirmed by serum Ferritin level and Iron studies including TIBC(Total Iron Binding Capacity), serum Iron level, serum Transferrin saturation etc., which are costly and time consuming investigations , and Mentzer index can predict the differentiation of B thalassemia trait from hypochromic microcytic anemia due to iron deficiency by a simple complete blood count. (10) Mentzer WC et in Turkey did a study on assessed 290 children between 1-16 years of age and utilized the RBC count, Red cell distribution width and Mentzer index (MCV/RBCs count ratio) for differentiating between carrier state of β thalassemia and IDA . it was found in these studies that Mentzer index is trustable discriminatory index, with a very high sensitivity (98.7%) and with specificity ( 82.3% ).In a study conducted by Ehsani et al , it was found that the reliable most index to differentiate was Mentzer index .…”

Section: Discussionmentioning

confidence: 99%

Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC

Idrees¹,

Khan²,

Riaz³

et al. 2023

PJMHS

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Objective: Aim was to evaluate the sensitivity and specificity of Mentzer index in differentiating beta thalassemia minor from anemia of Iron deficiency. Materials and Methods: A cross-sectional study conducted in Hematology unit of Hayatabad Medical Complex .Sampling was done non-consecutively. A total of 860 cases with value of Hemoglobin less than 11 Gm/DL were counted. In all the selected cases full blood count were checked and Mentzer Index mean corpuscular volume [MCV] per RBCs count )was calculated. Value of <13 suggests the diagnosis of β Thalassemia minor/trait while more than 13 value is more indicative of Iron deficiency anemia (IDA). Confirmation of diagnoses was made by hemoglobin study using HPLC. Values for specificity and sensitivity for Mentzer Index were calculated for the two differentials of microcytic hypochromic anemia presenting with microcytosis and hypochromia. Results: Mean hemoglobin level of patients was 9.01±1.85. Minimum and maximum hemoglobin value was 2.90 and 11 g/dl. Mean RCB count was 4.66±4.59 minimum and maximum RCB count was 1.07 and 136. Mean MCV value was 63.89±9.01. Minimum and maximum MCV value was 39.40 and 92.10 respectively. Men Mentzer index was 15.70±7.68. Minimum and maximum Mentzer index value was 7.80 and 10.7 respectively. Based on Mentzer index criteria 489(56.86%) patients had iron deficiency anemia and 371(43.14%) patients had higher suspicion of beta thalassemia. Conclusion: It was concluded that for differentiation among Beta thalassemia minor and anemia of iron deficiency , Mentzer Index can be beneficial to discriminate with a high sensitivity as well as specificity percentage and thus through a cost effective way, only suspected cases of beta thalassemia trait/minor can be further confirmed by Hb Electrophoreses. Keywords: Mentzer Index, iron deficiency Anemia, beta Thalassemia minor

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Section: Discussionmentioning

confidence: 99%

Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC

Idrees¹,

Khan²,

Riaz³

et al. 2023

PJMHS

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“…Moreover, the specificity and sensitivity values, as well as the positive and negative predictive values among erythrocyte indices have been documented in many previous studies, yet with different results among population. In Thailand, formula of RDW/ RBC has been proved to be the most reliable index (10), whereas MI has a substantial concordance with the HbA2 result in western part of Indonesia (11). Furthermore, new modified cut-offs have been proposed for a better discrimination between IDA and BTC.…”

Section: Introductionmentioning

confidence: 99%

Erythrocyte Indices MCV and/or MCH as First Round Screening Followed by Hb-analysis for β-thalassemia Carrier State

et al. 2022

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BACKGROUND: Being located in the global thalassemia belt area, Indonesia is estimated harboring about 10% thalassemia carriers; however, screening program is still diversely scattered across the country. Numerous erythrocyte indices have been introduced to help identifying thalassemia carriers with contradictory results. Therefore, this study had compared the use of mean corpuscular volume (MCV) and/or mean corpuscular hemoglobin (MCH) values and the most erythrocyte indices used in Indonesia which were Mentzer Index (MI) and Shine & Lal Index (SLI), as a first attempt in a mass screening for β-thalassemia carrier.METHODS: This was a retrospective study, evaluating laboratory data from family members of thalassemia major subjects. The sensitivity and specificity of MI and SLI were calculated. HbA2 >3.5% was used as a golden standard for β-thalassemia carrier and DNA examination was conducted to confirm β-globin mutation.RESULTS: Out of 160, 28.8% of the subjects had low Hb concentration. Interestingly, 79.4% of the subjects had low MCV and/or MCH with or without low Hb concentration. In this study, specificity and sensitivity of MI were 82.2% and 83.8%, whereas of SLI were 96% and 40.5%, respectively. Low MCV and/or MCH had covered IVS1nt5 and Cd26 mutation at β-globin gene; whereas MI and SLI had missed some samples, leading to false negative of thalassemia carrier results, when using MI or SLI only.CONCLUSION: MCV<80 fl and/or MCH<27 pg is the best first round mass screening method for β-thalassemia carrier in a limited facility area. However, Hb electrophoresis should be gradually installed regionally in various places wherever possible, as well as DNA analysis to confirm the mutation for an optimal carrier diagnosis.KEYWORDS: HbA2, HbE, iron deficiency anemia, Mentzer Index, Shine and Lal Index

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Concordance Test of Various Erythrocyte Indices for Screening of Beta Thalassemia Carrier

Nurazizah¹,

Handika²,

Sahiratmadja³

et al. 2022

Indonesian J. Clin. Pathol. Med. Lab.

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Carrier screening for early detection of thalassemia in the general population needs a careful approach, especially inÂ areas with limited health services. Various erythrocyte indices have been introduced as options for the first stage; however,Â the low-reliability value of these erythrocyte indices remains the problem. This study aimed to determine the most reliableÂ index for screening beta-thalassemia carriers and distinguish it from iron deficiency anemia. A cross-sectional study wasÂ designed to explore thalassemia carrier status among medical students. Inter-rater reliability value of various indices wasÂ compared to Shine and Lal index. The Cohen's Kappa coefficient was calculated using SPSS v. 25.0. Among 320 respondents,Â 295 subjects were non-anemic and 25 were anemic subjects, whereas 105 subjects had low MCV and/or MCH values.Â Cohen's Kappa value showed moderate reliability results compared to Shine and Lal index for example Mentzer index (0.58),Â Ehsani index (0.57), Srivastava index (0.53), and Bordbar index (0.41), but showed very low-reliability results with Green andÂ King index (0.04). New cut-off indices based on Kumar et al. were also compared, resulting in moderate reliability results.Â Since there was no Hb-electrophoresis test, the sensitivities and specificities of those indices could not be calculated. For thisÂ reason, a complete blood count can only be used for the early stages of screening for beta-thalassemia carriers, whereasÂ Hb-electrophoresis and DNA tests were considered necessary to perform to confirm a diagnosis.

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The compatibility measurement of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening

Cited by 3 publications

References 0 publications

Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC

Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC

Erythrocyte Indices MCV and/or MCH as First Round Screening Followed by Hb-analysis for β-thalassemia Carrier State

Concordance Test of Various Erythrocyte Indices for Screening of Beta Thalassemia Carrier

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