scholarly journals Differentiation of Beta Thalassemia Trait and Iron Deficiency Anaemia by Red Cell Indices

2019 ◽  
Vol 13 (2) ◽  
pp. 39-41
Author(s):  
Md Nurunnabi ◽  
Mosammath Khadiza Mamdu ◽  
Mohammad Maksudur Rahman ◽  
Farzana Zafreen ◽  
Md Abdul Wahab
Keyword(s):  
Iron Deficiency ◽  
Predictive Value ◽  
Iron Deficiency Anaemia ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Deficiency Anaemia ◽  
Rbc Indices ◽  
Automated Cell Counter ◽  
Cell Counter

Introduction: Beta thalassaemia trait (β-TT) and iron deficiency anaemia (IDA) are the most frequent causes of hypochromic microcytic anaemia in Bangladesh. Differentiation between βTT and IDA is important for proper treatment of patients. Red blood cell (RBC) indices obtained from automated cell counter can be used to differentiate between two. Objective: To compare among three RBC indices; red cell distribution width (RDW), red cell distribution width index (RDWI) and Mentzer’s index to differentiate between βTT and IDA. Materials and Methods: This cross-sectional comparative study was conducted on 50 diagnosed cases of β-TT and 50 cases of IDA at the department of pathology, BNS Patenga, Bangladesh from January 2016 to December 2017. Patients with Hb <6.0 gm/dl was excluded because below this level IDA and β-TT morphologically become very much distinguishable. RDW, RDWI and Mentzer’s index were calculated from the automated cell counter. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to compare diagnostic value of the indices. Results: Mentzer’s index was found the most reliable index as it had the highest sensitivity 95.1% and specificity 84.8% for detecting IDA. RDWI showed much lower sensitivity 91.2% and specificity 66.2% while RDW showed sensitivity and specificity of 83.2% and 61.1% respectively. Conclusion: Mentzer’s index is a reliable and useful index for differentiation between IDA and β-TT compared to other two indices. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 39-41

Sideroblastic Changes Can Be Recognized in the Erythrogram.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4909-4909
Author(s):  
Alicia Rovó ◽  
Jakob R. Passweg ◽  
Geneviève Favre ◽  
Dominik Heim ◽  
Sandrine Meyer-Monard ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Predictive Value ◽  
Statistical Significance ◽  
Diagnostic Approach ◽  
Distribution Width ◽  
Rbc Indices ◽  
Scatter Plots ◽  
Bone Marrow Iron ◽  
Cell Counter

Abstract The scatter plots of red blood cells (RBC), called erythrogram produced by the ADVIA® 2120 cell counter gives a visual representation of RBC characteristics. Using a pair of threshold gates on each axis, nine areas are defined according to the cell volume and the hemoglobin (Hb) content. Normal RBC are distributed in the central quadrant. In diseases such as iron deficiency and thalassemia the erythrogram shows a characteristic pattern commonly used for diagnostic approach. We observed in patients, mainly with myeloid diseases with ringed sideroblasts (RS) in the bone marrow a particular erythrogram pattern with a broad distribution of the RBC and a marked variation in RBC size and hemoglobinization. From the central quadrant an abnormal RBC population shifts on an imaginary axis to the lower-left quadrant representing a tail advancing into the microcytic and hypochromic quadrants (Fig1). To confirm whether this particular erythrogram was predictive for bone marrow sideroblastic changes; we compared retrospectively the erythrogram of patients with RS to a group of myeloid diseases without RS. Between January 2004 and August 2005, 33 of 1973 cases with more than 15% of RS in the marrow were identified, 21/33 patients were evaluable (AML=2, MDS=13, MPS=1, MDS/MPS=3, non neoplasia=2). These patients were compared to 30 consecutive cases with myeloid diseases without RS (No RS) (AML=16, MDS=11, MPS=2, MDS/MPS=1). In addition to the erythrogram pattern, Hb, RBC indices, and bone marrow iron staining were analyzed in both groups. We defined two types of erythrogram pattern in respect of sideroblastic changes: a) typical (fig1) b) non typical: any other pattern (i.e. macrocytosis, fig 2). The erythrogram was typical in 17/21 patients with RS and in 0/30 patients with No RS (p&lt;0.0001). The positive predictive value for sideroblastic changes was 100% and the negative predictive value was 88%. Despite the RBC indices comparison showed statistical significance in some variables, they were not specific enough to identify sideroblastic changes. In the group with RS, mean cell Hb was lower (median 30.8 versus 33.6pg), RBC distribution width was higher (19.3 versus 16.5%), the % of hypochromic RBC was higher (5.3 versus 0.9%) and Hb content of reticulocyte was lower (33 versus 37 pg) compared to No RS patients (p&lt;0.05). This last index was particularly useful to rule out iron deficiency in RS group as a cause of hypochromic RBC changes, since in contrast to iron deficiency it was not decreased. In conclusion: sideroblastic changes can be recognized in the erythrogram. Indeed, despite myeloid diseases with RS are a heterogeneous group of diseases they have a common pattern of RBC distribution that can be considered as a kind of fingerprinting for sideroblastic changes with a high predictive value allowing a straightforward diagnostic approach in clinical practice. Figure 1 Figure 1. Figure 2 Figure 2.

scholarly journals A Screening Test for Iron Deficiency Anaemia and Thalassaemia Traits

2015 ◽  
Vol 32 (4) ◽  
pp. 190-193
Author(s):  
Amin Lutful Kabir ◽  
Tashmim Farhana Dipta ◽  
Hajera Khatun ◽  
Mohammad Hafizur Rahman ◽  
Mahfuz Haq ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Predictive Value ◽  
Iron Deficiency Anaemia ◽  
Osmotic Fragility ◽  
Red Cell ◽  
Deficiency Anaemia ◽  
Final Study ◽  
Thalassaemia Trait ◽  
Study Population

Both iron deficiency and thalassaemia trait can present with hypochromic microcytic morphology. Naked eye single tube red cell osmotic fragility (NESTROF) is an inexpensive and simple test which can effectively differentiate iron deficiency anaemia from thalassaemia trait. Our study was an opportunity to observe the role of NESTROF in screening of thalassaemia trait among our study population. Initially NESTROF was carried out in 677 patients (N) population of four groups having both positive and negative NESTORF; for economical issue, auto-analyzer study and haemoglobin electrophoresis were done among only 100 randomly selected subjects, who were finally included in our study as final study population (n). In our study, NESTROF was 94.23% sensitive and its specificity was 92.08%. The predictive value of a positive test was 88.13% and predictive value of a negative test was 96.24%. Our study showed, NESTROF can effectively differentiate iron deficiency anaemia (IDA) from thalassaemia trait but, is not effective in co-existent IDA and thalassaemia.J Bangladesh Coll Phys Surg 2014; 32: 190-193

scholarly journals UTILITY OF BLOOD INDICES AND PARAMETERS FOR DIFFERENTIATING IRON DEFICIENCY ANAEMIA AND β-THALASSEMIA TRAIT BY CALCULATING VARIOUS DISCRIMINANT FUNCTIONS

2021 ◽  
pp. 144-146
Author(s):  
Mansi Davda ◽  
Sachin Patel ◽  
Kinalee Chothani ◽  
Jigna Upadhyay
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anemia ◽  
Red Cell ◽  
Discriminant Functions ◽  
Distribution Width ◽  
Deficiency Anaemia ◽  
Blood Indices ◽  
Thalassemia Trait ◽  
Rbc Count

The most commonly encountered disorders with microcytic anemia are iron deficiency anemia (IDA) and β-thalassemia trait (BTT).It is important to distinguish between IDA and BTT to avoid unnecessary iron therapy and the development of hemosiderosis.Various parameters obtained on automated haematology analyser by calculating discriminant functions have been helpful to differentiate iron deficiency anemia and β-thalassemia trait. Materials and Methods: This study was carried out in the pathology department of Gujarat Adani Institute Of Medical Science.We had studied 100 cases of differentiating Iron deficiency anaemia and β-Thalassaemia trait from patient's case records and laboratory reports irrespective of age and sex over a period of one year (January 2020 to December 2020).Tests for serum iron and ferritin were carried out in individuals showing low hemoglobin (Hb). All the selected subjects' samples were subjected to blood morphology, comparison of mean cell volume (MCV), RBC count, red cell distribution width (RDW), Red cell distribution width Index (RDWI),Srivastav Index(SI),Green and king Index (GI) and Mentzer's Index(MI). Results: Out of 100 cases seventy five were diagnosed having iron deficiency anaemia, whereas twenty five were having βthalassemia trait. The RBC count was higher and MCV was much lower in β-thalassemia trait as compared to iron deficiency anaemia.Both groups were subjected to RDW,RDWI,SI,MI and GI. Conclusion:Among various discriminant function calculated from different haematological parameters and blood indices,Mentzer index and Srivasta index are more sensitive and specific for differentiating iron deficiency anaemia and β-thalassemia trait.

scholarly journals RDWI is Better Discriminant than RDW in Differentiation of Iron Deficiency Anaemia and Beta Thalassaemia Trait

1970 ◽  
Vol 33 (3) ◽  
pp. 100-103 ◽  
Author(s):  
Ayatun Nesa ◽  
Md Abu Tayab ◽  
Tuhin Sultana ◽  
Lubna Khondker ◽  
Md Quddusur Rahman ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Distribution Width ◽  
Predictive Values ◽  
Deficiency Anaemia ◽  
Beta Thalassaemia

Iron deficiency anemia (IDA) and beta-thalassemia trait (BTT) are the common causesof microcytic hypochromic anaemia. Several discrimination indices have beenintroduced to discriminate quickly these similar entities via parameters obtained fromautomated cell counter. The purpose of the study was to compare the value of twodiscrimination indices, red cell distribution width index (RDWI) and red cell distributionwidth (RDW) in differentiation of BTT and IDA. This study consists of 57 cases ofBTT and 72 cases of IDA. Severe anaemia (<7.0 gm/dl) had been excluded becausethese cases are not confused with BTT cases in practice. Sensitivity, specificity,positive and negative predictive values and Youden’s index of both indices indifferentiation of BTT and IDA had been calculated. RDWI appears to be reliable anduseful index for differentiation of iron deficiency anaemia and beta thalassaemia trait.Again RDWI is better than RDW in differentiating BTT from IDA.Key words: Microcytic hypochromic anemia; discrimination indices.DOI: 10.3329/bjch.v33i3.5690Bangladesh Journal of Child Health 2009; Vol.33(3): 100-103

scholarly journals Red Cell Distribution Width (RDW) and Hb% in the Detection of Iron Deficiency Anemia in Pregnant Women

2018 ◽  
Vol 9 (2) ◽  
pp. 137-141
Author(s):  
Gazi Sharmin Sultana ◽  
Syed Aminul Haque ◽  
Ayatunnesa ◽  
Md MA Muttalib ◽  
Md Quddusur Rahman
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Red Cell Distribution Width ◽  
Deficiency Anemia ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Latent Iron Deficiency ◽  
Automated Hematology Analyzer

Background: Detection of iron deficiency early during pregnancy is essential for correct management. Red cell distribution width (RDW) is a new routine parameter in fully automated hematology analyzer that can give the idea of early iron deficiency before Hb%. This study was aimed to see the role of red cell distribution width and Hb% in determining early iron deficiency in pregnant women.Methods: In this study 190 pregnant women were included. CBC including Hb% and RDW and iron profile were done. RDW were compared with Hb% in various stages of iron deficiency.Results: RDW was more significant than Hb level in latent iron deficiency when Hb level was normal (p<0.05). In mild and moderate iron deficiency anemia, RDW was increased progressively though Hb level was reduced. In this study RDW had sensitivity 82.3% and specificity 97.4%. Whereas Hb level had sensitivity 56.6% and specificity 90.9% for iron deficiency.Conclusion: Latent iron deficiency without other complicating disease could be screened out early by increased RDW when Hb% was normal.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 137-141

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