Pseudothrombocytosis due to Microerythrocytosis: A Case of Beta Thalassemia Minor Complicated with Iron Deficiency Anemia

Background The most common diseases found with peripheral blood morphological features of hypochromic microcytic anemia are iron deficiency anemia and thalassemia. Hypochrome micrositer is a morphological description of red blood cells with MCV values smaller than normal (<80fl) and MCH smaller than normal values (<27pq). This morphological picture can be found in the condition of iron deficiency anemia and thalassemia. There are several markers for the assessment of Hb content in reticulocytes, including Ret-He. Ret-He, which can be measured by the latest automated hematological analysis, is considered to reflect the iron content in reticulocytes Aim Using Ret-He levels as a marker in distinguishing patients with β minor thalassemia and iron deficiency anemia. Method This research is an observational analytic study using case control measurement method, during April to July 2019 at the Department of Clinical Pathology, Faculty of Medicine, University of North Sumatra / H. Adam Malik General Hospital Medan. The population was students who were admitted to the University of North Sumatra who came for complete blood count examination. The subjects were students with MCV <80 fl, MCH <27 pq. Subjects who met the inclusion criteria then continued with the calculation of the Mentzer Index and RDW Index, ferritin serum examination using the ECLIA method, hemoglobin electrophoresis examination with micro capillary electrophoresis. By consecutive sampling, 42 samples were obtained, of which 21 subjects diagnosed with iron deficiency anemia and 21 subjects diagnosed with beta thalassemia minor were examined for their Ret-He levels using the flowsitometric method which were then analyzed statistically. Results From 21 iron deficiency anemia patients it was found that the average Ret-He value was 30.64 (6.08) pg and from 21 patients with beta minor thalassemia it was found that the average Ret-He value was 25.63 (6 , 72) pg. The results of the unpaired t-test for both groups obtained p = 0.016. By using the ROC curve obtained the Ret-He cut-off value in distinguishing cases of iron deficiency anemia with thalassemia was 27.30 pg with a sensitivity of 90.5% and specificity of 71.4%. Conclusion From the results of the study concluded that there was a significant difference between the levels of Ret-He in patients with iron deficiency anemia with thalassemia beta minor patients with a cut-off value of 27.30pg

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Difference of Het Re Level In Thalassemia β Minor And Iron Deficiency Anemia

STRADA JURNAL ILMIAH KESEHATAN ◽

10.30994/sjik.v9i2.515 ◽

2020 ◽

Vol 9 (2) ◽

pp. 1635-1641

Author(s):

Yustisia Amalia

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Complete Blood Count ◽

Deficiency Anemia ◽

Beta Thalassemia ◽

Inclusion Criteria ◽

Consecutive Sampling ◽

Thalassemia Minor ◽

Significant Difference ◽

The University

The population was students who were admitted to the University of Dr. Soetomo who came for complete blood count examination. The subjects were students with MCV <80 fl, MCH <27 pq. Subjects who met the inclusion criteria then continued with the calculation of the Mentzer Index and RDW Index, ferritin serum examination using the ECLIA method, hemoglobin electrophoresis examination with micro capillary electrophoresis. By consecutive sampling, 42 samples were obtained, of which 21 subjects diagnosed with iron deficiency anemia and 21 subjects diagnosed with beta thalassemia minor were examined for their Ret-He levels using the flowsitometric method which were then analyzed statistically.From the results of the study concluded that there was a significant difference between the levels of Ret-He in patients with iron deficiency anemia with thalassemia beta minor patients with a cut-off value of 27.30pg

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Application of Bayesian Decision Tree in Hematology Research: Differential Diagnosis of β-Thalassemia Trait from Iron Deficiency Anemia

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/6401105 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Mina Jahangiri ◽

Fakher Rahim ◽

Najmaldin Saki ◽

Amal Saki Malehi

Keyword(s):

Differential Diagnosis ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Hematological Parameters ◽

False Positive Rate ◽

Deficiency Anemia ◽

Beta Thalassemia ◽

Bayesian Tree ◽

Thalassemia Trait ◽

Cart Algorithm

Objective. Several discriminating techniques have been proposed to discriminate between β-thalassemia trait (βTT) and iron deficiency anemia (IDA). These discrimination techniques are essential clinically, but they are challenging and typically difficult. This study is the first application of the Bayesian tree-based method for differential diagnosis of βTT from IDA. Method. This cross-sectional study included 907 patients with ages over 18 years old and a mean (±SD) age of 25 ± 16.1 with either βTT or IDA. Hematological parameters were measured using a Sysmex KX-21 automated hematology analyzer. Bayesian Logit Treed (BLTREED) and Classification and Regression Trees (CART) were implemented to discriminate βTT from IDA based on the hematological parameters. Results. This study proposes an automatic detection model of beta-thalassemia carriers based on a Bayesian tree-based method. The BLTREED model and CART showed that mean corpuscular volume (MCV) was the main predictor in diagnostic discrimination. According to the test dataset, CART indicated higher sensitivity and negative predictive value than BLTREED for differential diagnosis of βTT from IDA. However, the CART algorithm had a high false-positive rate. Overall, the BLTREED model showed better performance concerning the area under the curve (AUC). Conclusions. The BLTREED model showed excellent diagnostic accuracy for differentiating βTT from IDA. In addition, understanding tree-based methods are easy and do not need statistical experience. Thus, it can help physicians in making the right clinical decision. So, the proposed model could support medical decisions in the differential diagnosis of βTT from IDA to avoid much more expensive, time-consuming laboratory tests, especially in countries with limited recourses or poor health services.

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