Red cell indices: differentiation between β-thalassemia trait and iron deficiency anemia and application to sickle-cell disease and sickle-cell thalassemia

2013 ◽  
Vol 51 (11) ◽  
Author(s):  
Chaima Abdelhafidh Sahli ◽  
Amina Bibi ◽  
Faida Ouali ◽  
Sondess Hadj Fredj ◽  
Boutheina Dakhlaoui ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Sickle Cell ◽  
Deficiency Anemia ◽  
Red Cell ◽  
Cell Disease ◽  
Red Cell Indices ◽  
Thalassemia Trait

The diagnosis of iron deficiency anemia in sickle cell disease

Blood ◽  
1981 ◽  
Vol 58 (5) ◽  
pp. 963-968 ◽  
Author(s):  
E Vichinsky ◽  
K Kleman ◽  
S Embury ◽  
B Lubin
Keyword(s):  
Sickle Cell Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Sickle Cell ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Zinc Protoporphyrin ◽  
Cell Disease ◽  
Iron Deficient

Abstract We determined the prevalence and optimal methods for laboratory diagnosis of iron deficiency anemia in patients with sickle cell disease. Laboratory investigations of 38 nontransfused and 32 transfused patients included transferrin saturation, serum ferritin, mean corpuscular volume (MCV), and free erythrocyte protoporphyrin (FEP). Response to iron supplementation confirmed the diagnosis of iron deficiency anemia in 16% of the nontransfused patients. None of the transfused patients were iron deficient. All iron-deficient patients (mean age 2.4 yr) had a low MCV, serum ferritin less than 25 ng/ml, transferrin saturation less than 15%, and FEP less than 90 micrograms/dl RBC. Following therapy, all parameters improved and the hemoglobin concentration increased greater than 2 g/dl. A serum ferritin below 25 ng/ml was the most reliable screening test for iron deficiency. There were 13% false positive results with transferrin saturation, 3% with MCV, and 62% with FEP. FEP values correlated strongly with reticulocyte counts. The high FEP was in part due to protoporphyrin IX and not completely due to zinc protoporphyrin, which is elevated in iron deficiency. We conclude that iron deficiency anemia is a potential problem in young nontransfused sickle cell patients. Serum ferritin below 25 ng/ml and low MCV are the most useful screening tests.

scholarly journals The diagnosis of iron deficiency anemia in sickle cell disease

Blood ◽  
1981 ◽  
Vol 58 (5) ◽  
pp. 963-968 ◽  
Author(s):  
E Vichinsky ◽  
K Kleman ◽  
S Embury ◽  
B Lubin
Keyword(s):  
Sickle Cell Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Sickle Cell ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Zinc Protoporphyrin ◽  
Cell Disease ◽  
Iron Deficient

We determined the prevalence and optimal methods for laboratory diagnosis of iron deficiency anemia in patients with sickle cell disease. Laboratory investigations of 38 nontransfused and 32 transfused patients included transferrin saturation, serum ferritin, mean corpuscular volume (MCV), and free erythrocyte protoporphyrin (FEP). Response to iron supplementation confirmed the diagnosis of iron deficiency anemia in 16% of the nontransfused patients. None of the transfused patients were iron deficient. All iron-deficient patients (mean age 2.4 yr) had a low MCV, serum ferritin less than 25 ng/ml, transferrin saturation less than 15%, and FEP less than 90 micrograms/dl RBC. Following therapy, all parameters improved and the hemoglobin concentration increased greater than 2 g/dl. A serum ferritin below 25 ng/ml was the most reliable screening test for iron deficiency. There were 13% false positive results with transferrin saturation, 3% with MCV, and 62% with FEP. FEP values correlated strongly with reticulocyte counts. The high FEP was in part due to protoporphyrin IX and not completely due to zinc protoporphyrin, which is elevated in iron deficiency. We conclude that iron deficiency anemia is a potential problem in young nontransfused sickle cell patients. Serum ferritin below 25 ng/ml and low MCV are the most useful screening tests.

Diagnosing sickle cell disease and iron deficiency anemia in human blood by Raman spectroscopy

2019 ◽  
Vol 35 (5) ◽  
pp. 1065-1074 ◽  
Author(s):  
Wagner Rafael da Silva ◽  
Landulfo Silveira ◽  
Adriana Barrinha Fernandes
Keyword(s):  
Raman Spectroscopy ◽  
Sickle Cell Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Sickle Cell ◽  
Human Blood ◽  
Deficiency Anemia ◽  
Cell Disease

scholarly journals Comparison of red cell distribution width and a red cell discriminant function incorporating volume dispersion for distinguishing iron deficiency from beta thalassemia trait in patients with microcytosis

1996 ◽  
Vol 114 (5) ◽  
pp. 1265-1269 ◽  
Author(s):  
Carmen Silvia Passos Lima ◽  
Aparecida Ribeiro de Carvalho Reis ◽  
Helena Zerlotti Wolf Grotto ◽  
Sara Teresinha Ollala Saad ◽  
Fernando Ferreira Costa
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Discriminant Function ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Thalassemia Trait

The red cell distribution width (RDW), and another red cell discriminant function incorporating RDW (MCV² x RDW/Hgb x 100) were determined in a group of 30 patients with iron deficiency anemia, 30 patients with beta thalassemia trait, and 30 normal subjects. Both RDW and (MCV² x RDW/Hgb x 100) mean values were significantly higher in iron deficiency anemia than in beta thalassemia trait (p<0.001). Taking RDW equal or above 21.0 percent among microcytic anemia patients, we identified correctly 90.0 percent of patients with iron deficiency anemia. The sensitivity and specificity of the test were 90.0 percent (IC 95 percent: 0.75 - 0.96) and 77.0 percent (IC 95 percent: 0.60 - 0.88), respectively. RDW values below 21.0 percent identified correctly 77.0 percent of beta thalassemia trait with a sensitivity and a specificity of 77.0 percent (IC 95 percent: 0.60 - 0.88) and 90.0 percent (IC 95 percent: 0.75 - 0.96), respectively. Taking values of (MCV² x RDW/Hgb x 100) above and below 80.0 percent as indicative of iron deficiency and beta thalassemia trait, respectively, we identified correctly 97.0 percent of those patients in each group. Both sensitivity and specificity were 97.0 percent (IC 95 percent: 0.84 - 0.99). These results indicated that the red cell discriminant function incorporating volume dispersion (MCV² x RDW/Hgb x 100) is a highly sensitive and specific method in the initial screening of patients with microcytic anemia and is better than RDW in differentiating iron deficiency anemia from beta thalassemia trait.

scholarly journals Correlation of red cell indices and hemoglobin concentration with serum ferritin among iron deficiency anemia patients

Biomedicine ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 268-273
Author(s):  
N. L Sharanya Raj ◽  
U Ajay Sharma ◽  
M. L Revathi Devi ◽  
S. M Purushothama ◽  
S. N Manjunath ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Hemoglobin Concentration ◽  
Developed Countries ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Red Cell ◽  
Distribution Width ◽  
Red Cell Indices

Introduction and Aim: Iron deficiency anemia is the commonest cause of anemia in developing country like India in all age groups. It is most easy to prevent as well as to treat. Its diagnosis and treatment are based on serum ferritin levels in developed countries which is not possible in India at primary healthcare setting. This study was undertaken to explore if red cell indices could replace serum ferritin in detecting iron deficiency. Materials and Methods: Study of association of red cell indices like Mean Corpuscular Volume (MCV), Mean Corpuscular hemoglobin (MCH), Mean Corpuscular hemoglobin Concentration (MCHC), Red cell Distribution Width (RDW) and Hemoglobin concentration (Hb%) with iron deficiency anemia and the correlation of these Red cell indices and Hb% with serum ferritin was done in 220 anemia patients of all age groups with Hb% <12g/dL. Results: Descriptive data showed skewed distribution of serum ferritin. Statistically significant reduction in all red cell indices values among iron deficiency anemia patients and statistically significant correlation of all red cell indices values except red cell distribution width with serum ferritin was found. Conclusion: Unlike developed countries we can use simple estimation of hemoglobin concentration along with red cell indices for diagnosing iron deficiency anemia in primary healthcare setting of India.  

scholarly journals Coexisting Iron Deficiency Anemia and Beta Thalassemia Trait: Effect of Iron Therapy on Red Cell Parameters and Hemoglobin Subtypes

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sarika Verma ◽  
Ruchika Gupta ◽  
Madhur Kudesia ◽  
Alka Mathur ◽  
Gopal Krishan ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Iron ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Oral Iron Therapy ◽  
Thalassemia Trait

Background. Coexistence of iron deficiency anemia (IDA) and beta thalassemia trait (BTT) has been the topic of few studies. However, no study from our country was found evaluating the effect of iron therapy in patients with concomitant IDA and BTT. Methods. Over a period of two years, 30 patients with concomitant IDA and BTT were included. All the patients had a complete blood count, serum iron studies, and thalassemia screening using BIORADTM hemoglobin testing system. The patients received oral iron therapy in appropriate dosages for a period of twenty weeks, after which all the investigations were repeated. Appropriate statistical methods were applied for comparison of pre- and posttherapy data. Results. All except two patients were adults with a marked female preponderance. Oral iron therapy led to statistically significant improvement in hemoglobin, red cell indices (P<0.05), and marked change in serum iron, ferritin, and HbA2 levels (P<0.001). There was a significant reduction in the total iron binding capacity levels. Conclusion. The present study shows the frequent occurrence of iron deficiency anemia in patients with beta thalassemia trait, which can potentially confound the diagnosis of the latter. Hence, iron deficiency should be identified and rectified in patients with suspicion of beta thalassemia trait.

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