scholarly journals The role of discriminant functions in screening beta thalassemia trait and iron deficiency anemia among laboratory samples

2017 ◽  
Vol 9 (03) ◽  
pp. 195-201 ◽  
Author(s):  
Ashwani Kumar ◽  
Debarshi Saha ◽  
Jyoti Kini ◽  
Nirupama Murali ◽  
Shrijeet Chakraborti ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Youden Index ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Discriminant Functions ◽  
Distribution Width ◽  
Sample Distribution ◽  
Thalassemia Trait

Abstract INTRODUCTION: Most important differential diagnosis for microcytosis and hypochromia is beta thalassemia trait (BTT) and iron deficiency anemia. AIM: To study the utility of discriminant functions (DFs) and red cell indices in distinguishing BTT and iron deficiency anemia. METHODS: The study is observational (cross sectional). A total of 350 patients, 43 BTT, and 307 iron-deficiency anemia reflecting actual disease prevalence were included. Their complete red blood cell parameters, hemoglobin A2, and serum ferritin level wherever required were obtained. Receiver operator characteristic curve was drawn for each DF and results compared with other studies. RESULTS: Among the six DFs, the highest sensitivity (97.7%) and specificity (98.6%) was shown, respectively, by Shine and Lal (S and L) and England and Fraser index (E and F) in identifying cases of BTT. Youden index of the Mentzer index (MI) was the highest (69.0) and S and L, the lowest (13.2) indicating MI to be the most efficient and the S and L, the least in differentiating the two entities. Red cell distribution width index (RDWI) showed the highest accuracy (91.6%), whereas S and L showed the least accuracy (29.6%). CONCLUSION: MI was the most efficient in discriminating BTT from iron deficiency anemia (IDA). RDWI stands to be the most accurate. S and L could at best be used as screening tool rather than DF. No study except one agreed with us because convenient sampling used in other studies generated bias in their results. Statistically, this study bears far more relevance than other studies because the sample distribution reflects the prevalence of IDA and BTT in the community.

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 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 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.

scholarly journals Validation of new indices for differentiation between iron deficiency anemia and beta thalessemia trait, a study in pregnant females

2018 ◽  
Vol 4 (2) ◽  
pp. 26
Author(s):  
Sheetal Arora ◽  
Deepshikha Rana ◽  
Sachin Kolte ◽  
Leelawathi Dawson ◽  
Indrani Dhawan
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Red Cell Distribution Width ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Pregnant Females ◽  
Youden’S Index

<p class="abstract"><strong>Background:</strong> The two most frequent types of microcytic hypochromic anemia in developing countries are beta thalassemia trait (𝛽-TT) and iron deficiency anemia (IDA). Several indices using blood cell count parameters have been suggested to differentiate between two. In this study we evaluated the reliability of three indices.</p><p class="abstract"><strong>Methods:</strong> The present cross-sectional study was carried out in 300 pregnant females in third trimester. Out of these, 90 microcytic hypochromic females were selected. Mentzers index, red cell distribution width index and Matos and Carvalho index (MCI) were calculated from the regular 3-part analyser haematological parameters.  </p><p class="abstract"><strong>Results:</strong> The Mentzer index was the most reliable index, as it had the highest sensitivity (97.62%), specificity (66.67%), and Youden’s index (64%) for detecting Iron deficiency anaemia; the Matos and Carvalho Index showed higher sensitivity (98.81%)but a much lower specificity (33.3%) and Youden’s index (32%) while the red cell distribution width index showed the sensitivity and specificity of 92.86% and 66.67%, respectively with Youden’s index of 59%.</p><p class="abstract"><strong>Conclusions:</strong> The Mentzer index provided the highest reliabilities for differentiating<strong> </strong>IDA from 𝛽-TT. The new indices have high sensitivities and positive predictive value for identifying IDA, making them useful for screening population at risk. </p>

Evaluation of Twenty Four Discriminant Indices for Differentiating Beta-Thalassemia Trait from Iron Deficiency Anemia in Egyptians

2019 ◽  
Author(s):  
Shaimaa Abdelmalik Pessar
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Complete Blood Count ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
True Negative ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Distribution Width ◽  
Thalassemia Trait

Background: Many Red Blood Cell (RBC) indices have been developed based on mathematical formulae to discriminate beta-thalassemia trait (βTT) from iron deficiency anemia (IDA). The latter two conditions represent the most common causes of microcytic hypochromic anemia in Egypt. This study aimed To evaluate the diagnostic reliability of 24 published discriminant indices for differentiating βTT from IDA in Egyptians. Materials and Methods: A cross sectional study included a total of 166 subjects (108 IDA & 58 βTT) aged 1-18 years were recruited from Hematology laboratory of  Pediatric Hospital, Ain Shams University, Cairo, Egypt. A full diagnostic algorithm was performed using complete blood count, hemoglobin electrophoresis by High Performance Liquid Chromatography (HPLC), iron profile and PCR detection of 22 mutations common for βTT. Twenty-four formulas were applied and their performance characteristics were calculated for each index. Results: The highest accuracy (True positive + True negative/ All cases) & Youden's Index (Sensitivity+Specificity-100) were for Red Cell Distribution Width (RDWI) and Hameed index closely followed by Keikhaei index while the least performance was for RDW-SD, RDW-CV and Shine & Lal indices. Conclusion The superiority of an index over another in distinguishing βTT from IDA allowed only partially better selection of cases warranting further confirmatory molecular studies. None of the studied formulae provided a surrogate test for Hb electrophoresis as mass screening.

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

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