Value of discrimination indices in screening of beta thalassaemia trait

Nesa, Ayatun; Munir, SK Farhad; Sultana, Tuhin; Rahman, Quddusur; Shomik, Mohammed Shohel; Ahmed, AN Nashimuddin

doi:10.3329/bjpath.v25i1.4126

Cited by 4 publications

(11 citation statements)

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“…The percentage of hypochromic cells, defined as RBC with low haemoglobin concentration, tends to be higher in patients with IDA than in thalassaemia carriers, while the percentage of microcytes, increased in thalassaemia carriers, shows the opposite trend; the quotient % Micro/% Hypo, M/H ratio amplifies the difference between the two groups 10,12,17 . However, the reason for the discrepancies among the various studies may be also due to the different sample size and the inclusion of patients with severe and mixed cases of thalassaemia and iron deficiency anaemia.…”

Section: Methodsmentioning

confidence: 95%

“…There are only few studies reported previously on the M/H ratio [10][11][12] . The reference ranges for the new RBC extended parameters and their values in anaemic patients with red cells abnormalities have been recently established 5,17 .…”

Section: Discussionmentioning

confidence: 99%

“…M/H ratios were calculated from the thalassaemia trait & other haemoglobinopathies 4,5 6,7 . Several screening procedures have been devised but these are neither cost effective nor sensitive enough [8][9][10][11] . A simple procedure utilizing cell counter introduced recently, for discrimination of beta-thalassaemia trait from iron deficiency anemia, is the ratio between percentage of microcytic and hypochromic red cells (M/H ratio) [10][11][12] .…”

Section: Methodsmentioning

confidence: 99%

“…Several screening procedures have been devised but these are neither cost effective nor sensitive enough [8][9][10][11] . A simple procedure utilizing cell counter introduced recently, for discrimination of beta-thalassaemia trait from iron deficiency anemia, is the ratio between percentage of microcytic and hypochromic red cells (M/H ratio) [10][11][12] . The quantification of the percentages of microcytic and hypochromic erythrocytes has proved clinically useful in the differential diagnosis between thalassaemic and nonthalassaemic microcytosis 12 .…”

Section: Methodsmentioning

confidence: 99%

“…Quality control was also performed within assay and between assays running of controls. The sensitivity, predictive value and diagnostic accuracy of M/H ratio for Beta-thalassaemia trait was calculated according to the method of Galen and Gambino [1][2][3][10][11][12][13][14][15][16][17] .…”

Section: Methodsmentioning

confidence: 99%

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A Multicentre Based Observation of a Screening tool to Differentiate Microcytosis and Hypochromia

Dipta

Kabir

Rahman

et al. 2017

Anwer Khan Mod Med Coll J

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Back ground: Iron deficiency anemia (IDA) and beta-thalassaemia trait (B-TT) are the most common causes of hypochromic microcytic anemia. Many indices have been defined to quickly discriminate these similar entities via parameters obtained from automated blood count analyzers.Methodology: The purpose of the study was to evaluate the predictive value of these indices in differential diagnosis of IDA and B-TT in adult cases. In this study we use auto-analyzer based formula of percentages of microcytic and hypochromic red cells (M/H ratio=% of Microcytosis/% of Hypochromia) as a screening tool for thalassaemia trait in Bangladeshi population.Results: A total of 150 subjects w ere included in this study with 50 known obligate carrier of beta-thalassaemia trait and 100 patients with hypochromia and microcytosis. Confirmatory tests for IDA were performed if serum ferritin level was <12 ng/ml and confirmatory test for Beta-thalassaemia trait (BTT) and Haemoglobin E trait can be considered when HbA2 > 3.5% , on agarose gel Haemoglobin electrophoresis at an alkaline pH (8.6) where, in addition, MCV <76 fl and/or MCH <27 pg. BTT was selected with HbA2 >3.5%, while the non- BTT group were those with HbA2 <3.5%.The final analysis of the result revealed that M/H ratio is a very sensitive index for betathalassaemia trait. In our study, the sensitivity, predictive value and diagnostic accuracy of the M/H ratio for the beta thalassaemia trait were 96%, 90.4% and 90.4% respectively and also identify all cases of coexistent iron deficiency.Conclusion: Thus M/H ratio is an easy, reliable and sensitive index which can be used for mass screening of betathalassaemia trait, particularly in a population where iron deficiency anemia is also prevalent.Anwer Khan Modern Medical College Journal Vol. 7, No. 1: Jan 2016, P 5-10

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Section: Methodsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

A Multicentre Based Observation of a Screening tool to Differentiate Microcytosis and Hypochromia

Dipta

Kabir

Rahman

et al. 2017

Anwer Khan Mod Med Coll J

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Evaluation of the new red cell parameters on Beckman Coulter DxH800 in distinguishing iron deficiency anaemia from thalassaemia trait

Leung

Lau

et al. 2014

Int J Lab Hematology

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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.

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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.

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Value of discrimination indices in screening of beta thalassaemia trait

Abstract: Key words: Beta thalassaemia; discrimination indicesDOI: 10.3329/bjpath.v25i1.4126Bangladesh J Pathol 25(1): 14-17

Cited by 4 publications

References 0 publications

A Multicentre Based Observation of a Screening tool to Differentiate Microcytosis and Hypochromia

A Multicentre Based Observation of a Screening tool to Differentiate Microcytosis and Hypochromia

Evaluation of the new red cell parameters on Beckman Coulter DxH800 in distinguishing iron deficiency anaemia from thalassaemia trait

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

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