DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20174666

Study of blood indices and high performance liquid chromatography (HPLC) in differentiation of β-thalassemia trait and iron deficiency anaemia

Pravin M. Meshram, Hemant R. Kokandakar, Rajan S. Bindu

Abstract


Background: Iron deficiency anemia (IDA) and beta thalassaemia trait (BTT) are two of the most common causes of microcytic anemia.It is essential to differentiate between the two, so as to avoid unnecessary iron therapy which is contraindicated in beta thalassaemia .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 200 patients were evaluated. We calculated 6 discrimination indices in all patients with anemia or suspected beta thalassemia. None of the subjects had  combined  IDA and 𝛽-TT. The patient groups were evaluated according to  the Mentzer, Shine and Lal, England and Fraser,Srivastava, Green and King, Ricerca.

Results: According to percentage correctly diagnosed criteria, Ricerca  and Mentzer  index are considered as the two best discrimination indices in differentiation between β thalassemia trait  and iron deficiency anaemia .Youden’s index showed the following ranking with respect to the indices’ ability to distinguish between 𝛽-TT and IDA, Ricerca index >  Mentzer index > Green and King index >  Srivastava index >  Shine and Lal index > England and Fraser index.

Conclusions: Ricerca  and Mentzer  index are considered as the two best discrimination indices in differentiation between β thalassemia trait  and iron deficiency anaemia.

Keywords: Iron deficiency anemia (IDA) and beta thalassaemia trait (𝛽-TT) 


Keywords


Beta thalassaemia trait, Iron deficiency anemia, Mentzer index, Ricerca index

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References


Wintrobe MM, Lee GR. Wintrobe's Clinical Hematology. 10th ed. 1998.

Rangan A, Handoo A, Sinha S, Saxena R, Verma IC, Kumar S et al. Utility of family studies in diagnosing abnormal hemoglobins/ thalassemic states. Indian J Pediatr. 2009 June;76(6):615-21.

Akai Y, Kubota F, Bichile SK, Mehta NB. A Study of beta thalassemia screening using an automated hematology analyser. Symex J int. 1998;8(2).

Cartwright GE, Lee GR. The anaemia of chronic disorders. Br J Hematol. Br J Haematol. 1971 Aug;21(2):147-52.

Bainton DF, Finch CA. The diagnosis of iron deficiency anemia. Am J Med. 1964 Jul 1;37(1):62-70.

Biorad: Instruction manual 2006. Variant Beta-thalassemia short program. Available at: http://www.bio-rad.com/ en-us/ product/ hemoglobinopathies/ variant-ii-beta-thalassemia-short-program-reorder-pack.

Ehsani MA, Shahgholi E, Rahiminejad MS, Seighali F, Rashidi A. A new index for discrimination between iron deficiency anemia and beta-thalassemia minor: results in 284 patients. Pak J Biol Sci: PJBS. 2009 Mar;12(5):473-5.

Rahim F, Keikhaei B. Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait. Turk J Hematol. 2009 Sep 1;26(3):138-45.

Niazi M, Tahir M, e Raziq F, Hameed A. Usefulness of Redcell Indices in Differentiating Microcytic Hypochromic Anemias. Gomal J Med Sci. 2010 Dec 31;8(2).

Matos JF, Dusse LM, Stubbert RV, Ferreira MR, Coura-Vital W, Fernandes AP et al. Comparison of discriminative indices for iron deficiency anemia and β thalassemia trait in a Brazilian population. Hematology. 2013 May 1;18(3):169-74.

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 Apr 10;2014.

Okan V, Cigiloglu A, Cifci S, Yilmaz M, Pehlivan M. Red cell indices and functions differentiating patients with the β-thalassaemia trait from those with iron deficiency anaemia. J Int Med Res. 2009 Feb;37(1):25-30.

Keikhaei B. A new valid formula in differentiating iron deficiency anemia from ß-thalassemia trait. Pak J Med Sci. 2010;26:368-73.

TP, SA. Discriminant functions in distinguishing beta thalassemia trait and iron deficiency anemia: the value of the RDW-SD. Internet J Hematol. 2010;7(2).

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. PloS one. 2015 Feb 13;10(2):e0114061.

Sehgal K, Mansukhani P, Dadu T, Irani M, Khodaiji S. Sehgal index: A new index and its comparison with other complete blood count-based indices for screening of beta thalassemia trait in a tertiary care hospital. Indian J Pathol Microbiol. 2015;58(3):310.