NEW INDICES FOR DIFFERENTIATION BETWEEN IRON DEFICIENCY ANEMIA AND BETA THALESSEMIA TRAIT, A STUDY IN CHILDREN.

  • Bsc.In haematology, Master of Science in haematopathology.
Crossref Cited-by Linking logo

  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

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.

  1. Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N,Lozano R, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014; 123(5):615?24.
  2. Pasricha SR. Anemia: a comprehensive global estimate. Blood.2014; 123(5):611?2.
  3. World Health Organization. The global prevalence of anaemia in 2011. Available http://www.who.int/nutrition/publications/micronutrients/globalprevalence anaemia 2011/en/.
  4. Mathers C, Steven G, Mascarenhas M. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization; 2009.
  5. Rathod D. A., Kaur A., Patel V. et al., ?Usefulness of cell counter based parameters and formulas in detection of -thalassemia trait in areas of high prevalence,? American Journal of Clinical Pathology.2007; vol. 128, no. 4, pp. 585?589.
  6. Urrechaga, L. Borque, and J. F. Escanero, ?The role of automated measurement of RBC subpopulations in differential diagnosis of microcytic anemia and -thalassemia screening,? American Journal of ClinicalPathology. 2011; vol. 135, no. 3, pp. 374?379.
  7. Thomas C. and Thomas L., ?Biochemical markers and hematologic indices in the diagnosis of functional iron deficiency,? ClinicalChemistry.2002; vol. 48, no. 7, pp. 1066?1076.
  8. Vehapoglu A, Ozgurhan G, Demir AD, Uzuner S, Nursoy MA, Turkmen S, et al. Hematological indices for differential diagnosis of beta thalassemia trait and iron deficiency anemia. Anemia. 2014; 10 (5):1-7.
  9. Bordbar E, Taghipour M, ZucconiBE. Reliability of different RBC indices and formulas in discriminating between β-Thalassemia minor and other microcytic hypochromic cases. Mediterr J Hematol Infect Dis. 2015; 7(1):1-12.
  10. Huang TC, Wu YY, Chen YG, Lai SW, Wu SC, Ye RH, et al. Discrimination Index of Microcytic Anemia in Young Soldiers: A Single Institutional Analysis. Plo S One. 2015; 10(2):1-10.
  11. Ismail M, Patel NG. Evaluation of the Diagnostic Accuracy of Twelve
  12. Discrimination Indices for differentiating β-thalassemia Trait from Iron Deficiency Anemia. Indian J Public Health Res Dev. 2016; 7(1):104-109.
  13. Verma S, Gupta R, Kudesia M, Mathur A, Krishan G, Singh S. Coexisting iron deficiency anemia and Beta thalassemia trait: effect of iron therapy on red cell parameters and hemoglobin subtypes. ISRN Hematol. 2014; 12(3):1-4.
  14. Hoffmann JJ, Urrechaga E, Aguirre U. Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis. CCLM. 2015; 53(12):1883-94 Plengsuree S, Punyamung M, Yanola J, Nanta S, Jaiping K, Maneewong
  15. K, et al. Red cell indices and formulas used in differentiation of β-thalassemia trait from iron deficiency in Thai adults. Hemoglobin. 2015; 39(4):235-9.
  16. Mentzer WC Jr. Differentiation of iron deficiency from thalassaemia trait. Lancet. 1973; 1(7808):882.
  17. Thein SL and Rees D. Haemoglobin and the inherited disorders of globin synthesis. In: Hoffbrand AV, Higgs DR, Keeling DM and Mehta AB (eds). Postgraduate haematology.11th WielyBackwell 2016; p 85.
  18. Wild BJ and Bain BJ. Investigation of variant haemoglobins and thalassaemias. In: Bain BJ, Bates I, Lewis SM and Laffan MA. (eds). Dacie and Lewis Practical Haematology. 12th US: Elsevier 2017. P 308.
 
  1. Patra S, Adhikari BC. International Journal of Scientific research.2017; vol.6, no. 2272, pp 40- 41.
  2. Rahim F and Keikhaei B. Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait. Turkish J Hematol. 2009; 26 (3):138?
  4. Ehsani M.A, Shahgholi E, Rahiminejad M.S, Seighali F, and Rashidi A. A new index for discrimination between iron deficiency anemia and beta-thalassemia minor: results in 284 patients. Pakistan J Biological Sci. 2009; 12(5):473?5.
  5. Arora1 S., Rana D., Kolte S., Dawson L and Dhawan I. Validation of new indices for differentiation between iron deficiency anemia and beta thalessemia trait, a study in pregnant females. International Journal of Scientific Reports. 2018 Feb; 4 (2):26-30.

[MunaAbdulmueen Abdullah. (2018); NEW INDICES FOR DIFFERENTIATION BETWEEN IRON DEFICIENCY ANEMIA AND BETA THALESSEMIA TRAIT, A STUDY IN CHILDREN. Int. J. of Adv. Res. 6 (Sep). 587-592] (ISSN 2320-5407). www.journalijar.com

Muna Abdulmueen Abdullah
Bsc. In haematology, Master of Science in haematopathology.

DOI:

Article DOI: 10.21474/IJAR01/7713      
DOI URL: https://dx.doi.org/10.21474/IJAR01/7713

Download Full Paper

Download PDF No. of Downloads: 24 | No. of Views: 53