EVALUATION OF DIAGNOSTIC ACCURACY OF HEMATOLOGICAL INDICES IN THE DIFFERENTIATION OF BETA THALASSEMIA TRAIT FROM IRON DEFICIENCY ANEMIA

2021 ◽  
pp. 24-26
Author(s):  
Kavita Choudhary ◽  
M. L Gupta ◽  
Monika Hemin Shroff ◽  
Abhishek Rajawat
Keyword(s):  
Predictive Value ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Hematological Indices ◽  
Medical College ◽  
Red Cell Indices ◽  
Thalassemia Trait ◽  
Youden’S Index

Background: 2 most frequent type of microcytic hypochromic anemias are Iron deciency anemia (IDA) and beta thalassemia trait (β-TT) continue to be a cause of signicant burden to the society, particularly in developing countries like INDIA, where there is limitation of resources. The objective of the present study was to evaluate the validity of different discrimination indices to differentiate β-TTfromIDA. Methods:All diagnosed patients of microcytic hypochromic anemia admitted in Geetanjali Medical College and Hospital, Udaipur (Raj) between Jan 2018 to June 2020, were included in this study. Sensitivity, specicity, positive predictive value (PPV), negative predictive value (NPV) and Youden's index (YI) were calculated. Result: According to our study following rankings of various discrimination indices were obtained for BTT patients, RDW Index > Mentzer's Index = Ehsani Index > Sirdah Index > MDHLIndex > MCHD Index. Conclusion: According to our results and observations, the percentage of correctly diagnosed patients are the highest with RDW Index and Mentzer's Index. It should be kept in mind that several studies have shown that none of the red cell indices carry 100% sensitivity and specicity in diagnosing BTT.

scholarly journals Pattern of Red Cell Count and Red Cell Distribution Width (RDW %) in Beta Thalassaemia Trait in Adults

2018 ◽  
Vol 9 (1) ◽  
pp. 31-35
Author(s):  
MMU Rahman ◽  
M Nayem ◽  
W Begum ◽  
FA Begum ◽  
MNU Ahmed ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Cell Count ◽  
Iron Deficiency Anemia ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Red Cell Count ◽  
Thalassemia Trait ◽  
Rbc Count

Microcytic hypochromic anemia is one of the commonest hematological abnormalities in Bangladeshi population. Iron deficiency anemia and beta thalassemia traits are the most frequent causes of microcytic hypochromic anemia which are sometimes difficult to differentiate clinically and by routine laboratory examinations due to similar blood picture. To differentiate between patients of beta thalassemia trait and iron deficiency anemia, physicians need a group of investigations including peripheral blood film, estimation of HbA2, serum ferritin, serum iron, total iron binding capacity and transferrin saturation. But these tests are relatively expensive, time consuming and need sophisticated techniques. The aim of this study was to evaluate the pattern of red cell count and RDW-CV (%) in beta thalassemia trait in adults and thereby determine the role of these parameters in differentiation between patients of beta thalassemia trait and iron deficiency anaemia. In this study 50 confirmed cases of beta thalassemia trait aged 18 to 60 years, both male and female were included as cases and 50 age- and sex-matched iron deficiency subjects were included as control. RBC count and RDW-CV (%) were measured by an electronic cell counter device. The present study revealed that RBC count was higher in patients with beta thalassemia trait than that in iron deficiency anemia and RDW-CV(%) was significantly higher in patients with iron deficiency anemia than that in beta thalassemia trait.Bangladesh J Med Biochem 2016; 9(1): 31-35

scholarly journals Effects of vitamin D supplementation on red cell indices and cytokines in patients with thalassemia: An open-label randomized clinical trial

2019 ◽  
pp. 170-179
Keyword(s):  
Clinical Trial ◽  
Vitamin D ◽  
Randomized Clinical Trial ◽  
Thalassemia Major ◽  
Vitamin D Supplementation ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Open Label ◽  
Hematological Indices ◽  
Red Cell Indices

Background and aim Deficiency of vitamin D is known as a health problem all over the world and a recognized clinical complication of beta thalassemia patients. Vitamin D acts as a hormone at the nuclear receptor rendering it a beneficial medication for a number of diseases. It is believed that vitamin D is important in the modulation of the inflammation system by regulating the formation of inflammatory cytokines and immune cells. This study aimed to investigate the effect of vitamin D supplementation on the red cell indices and cytokines levels in patients with beta thalassemia major, in an open label randomized clinical trial. Patients and Methods: this study performed an open-label randomized clinical trial in patients with beta thalassemia major. Forty-six patients completed the eight weeks clinical trial and were allocated to administer oral vitamin D3 supplement of 100,000 IU every two weeks as an add-on treatment. During the study, hematological indices, serum iron, ferritin, vitamin D, calcium and inflammatory markers (interleukin-6, interleukin-2 and interleukin-10) were evaluated before (at baseline) and after vitamin D supplementation for 8 weeks. Results: Vitamin D3 supplements significantly decreases interleukin-6 levels and elevates the serum levels of anti-inflammatory cytokines IL-2 and IL-10, it also significantly reduced serum ferritin level, but it did not alter the hematological indices. Conclusion: Our results suggest that administration of vitamin D has a potential anti-inflammatory role in beta thalassemia patients and reduces serum ferritin levels, which may reduce the burdens of iron overload in thalassemia patients.

scholarly journals Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices

2017 ◽  
Vol 33 (3) ◽  
Author(s):  
Tahir Ahmed Jameel ◽  
Mukhtar Baig ◽  
Ijaz Ahmed ◽  
Muhammad Barakat Hussain ◽  
Motlag bin Doghaim Alkhamaly
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Hematological Indices ◽  
Thalassemia Trait

scholarly journals Role of Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) in Detecting Beta-Thalassemia Trait

2018 ◽  
Vol 36 (4) ◽  
pp. 145-152 ◽  
Author(s):  
Asma Ferdousi ◽  
Mainuddin Ahmad ◽  
Jhulan Das Sharma ◽  
Rasheda Samad ◽  
AKM Zafar Ullah
Keyword(s):  
Predictive Value ◽  
Disease Incidence ◽  
Osmotic Fragility ◽  
Beta Thalassemia ◽  
Red Cell ◽  
College Hospital ◽  
Single Tube ◽  
Naked Eye ◽  
Thalassemia Trait

Thalassemia is one of the commonest inherited diseases in Bangladesh. The birth of a thalassemic child places considerable strain, not only on the affected child and its family but also on the community and the nation at large. To reduce the burden of the society and to reduce the disease incidence by providing genetic counseling, detection of carrier is important. The present study evaluates the role of ‘Naked Eye Single Tube Red Cell Osmotic Fragility Test’ (NESTROFT) in detecting ß-thalassemia trait. The current study is a cross sectional study done during the period of September 2008 to August 2009. The study subjects were sibs, parents and relatives of thalassemia patients of age more than 1 year attending Pediatric department of Chittagong Medical College Hospital. Sample size was 50. Here subjects with lowered osmotic fragility test were detected and later on Hb- electrophoresis was done. All the data were recorded and analyzed by SPSS programme. The Sensitivity, Specificity and predictive value of positive and negative tests were computed and they were 92.6%, 80%, 92.6% and 80% respectively. False positive cases were found. The present study found NESTROFT to be both sensitive and reasonably specific and of high negative predictive value. However, multicenter study with large sample is needed to recommend NESTROFT as a single screening test for detection of ß-thalassemia trait.J Bangladesh Coll Phys Surg 2018; 36(4): 145-152

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 Indices in differentiating iron deficiency anemia from thalassemia trait- a comparative study

2021 ◽  
Vol 12 (10) ◽  
pp. 81-86
Author(s):  
Sufia Ahmad ◽  
Noorin Zaidi ◽  
Syed Riaz Mehdi ◽  
Sumaiya Irfan ◽  
Sharique Ahmad
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Hypochromic Anemia ◽  
Bone Marrow Examination ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Blood Samples ◽  
Biochemical Assays ◽  
Different Types ◽  
Thalassemia Trait

Background: Iron deficiency anemia (IDA) and beta thalassemia trait (BTT) are the two most common and important causes of microcytic hypochromic anemia in India. It is very difficult to differentiate between the two. Many different types of techniques have been proposed for the same. While some are invasive like bone marrow examination others are not available at all centers, like electrophoresis. Hence different indices come into play. Aims and Objective: This study was undertaken to compare the efficacy of Shine and Lal index and Mentzer index in differentiating between IDA and BTT. Materials and Methods: A total of 407 anemia cases were studied over a period of 18 months and their blood samples were subject to different hematological and biochemical assays to diagnose the type of anemia. Results: Based on these tests 92.1% cases were found to be of IDA whereas 3.7% cases were found to be of BTT. Then both the indices were applied in the above mentioned cases. Conclusion: While Shine and Lal index was found to have better sensitivity, Mentzer index was found to have better specificity.

scholarly journals “PREVALENCE OF BETA-THALASSEMIA TRAIT IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC”

2021 ◽  
pp. 45-47
Author(s):  
Uma Jain ◽  
Preeti Gupta ◽  
Shaily Sengar
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Gestational Age ◽  
High Performance ◽  
Hypochromic Anemia ◽  
Antenatal Clinic ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Thalassemia Trait

INTRODUCTION- Iron deficiency anemia and thalassemia syndromes,especially beta thalassemia trait (BTT),are the two most commonly ccuring microcytic hypochromic anemias highly prevalent in countries like India. Iron deficiency anemia is the first most common cause of anemia in pregnancy,beta thalassemia trait is the second most frequent cause of anemia of pregnancy. Patients with thalassemia trait shows an increased incidence of anemia during the second trimester of pregnancy. Beta Thalassemia Trait (BTT) patients are usually asymptomatic and ignorant of their carrier state unless diagnosed by testing. Screening for thalassemia can be done by measuring HbA2 levels MATERIAL AND METHOD- This is a retrospective study. The data were collected from a clinic and associated st pathology in Shivpuri and a private maternity hospital in Gwalior from 1 January 2019 to 30 June 2021.94 patients were included in the study.All pregnant women between the age of 18-45 years and at any gestational age with hemoglobin level <10g/dL and microcytic hypochromic anemia (report of CBC) were included in the study. High-Performance Liquid Chromatography (HPLC) and serum ferritin report were collected. RESULTS- In our study the most common age group in which the anemia was found between 19-35 years (80.85%).Most of the patients were primigravida (44.68%),between 26-37 wks of gestational age (82.97%),from a rural area (70.21%). Only 2 patients had a family history (2.12%) of beta-thalassemia and 6 patients had a history (6.38%) of blood transfusion. In our study moderate anemia was found in 55.31% of cases followed by mild anemia 25.53% and severe anemia 19.14%. In our study iron deficiency anemia was found in 87.23% only minor Beta-thalassemia was found to be 4.25%, of the patient,and the coexistence of iron deficiency anemia and beta-thalassemia in pregnant women is 8.51%. In our study total of 12 patients (4 cases of only minor beta-thalassemia and 8 cases of minor beta-thalassemia associated with IDA) The prevalence rate of beta-thalassemia in our study was 7.8%. CONCLUSION- the recommendation is to diagnose beta-thalassemia in pregnant patients is essential to give proper treatment.The screening of pregnant patients prevents unnecessary parental iron therapy and iron overload in case of anemia.further studies are needed in this field and less expensive and accurate methods should come in place.

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