scholarly journals Determination of Red Cell Indices Cut-off for Identifying Iron Deficiency Anaemia among Pre-school Children with Sickle Cell Anaemia

2020 ◽  
pp. 357-364
Author(s):  
OS Akodu ◽  
FA Adekanmbi ◽  
TA Ogunlesi
Keyword(s):  
Iron Deficiency ◽  
Sickle Cell ◽  
School Children ◽  
Iron Deficiency Anaemia ◽  
Sickle Cell Anaemia ◽  
Red Cell ◽  
Predictive Values ◽  
Deficiency Anaemia ◽  
Red Cell Indices ◽  
Discriminatory Performance

Nigerian pre-school children have a high risk of developing iron deficiency and there is no consistent evidence that patients with sickle cell anaemia are protected from iron deficiency anaemia. The objective is to explore red cell indices cut-off values useful as surrogate for detecting iron deficiency in children with sickle cell anaemia. Ninety-seven children with sickle cell anaemia were recruited from Children Outpatient. Reference intervals were developed using the 2.5th – 97.5th, 3.0rd – 97.0th, 5 – 95th, and 10th – 90th percentile intervals for MCV and MCH. The discriminatory performance of the proposed red cell indices criterion was assessed by use of sensitivity, specificity, accuracy, likelihood ratio and predictive values. The 2.5th, 3rd, 5th, 10th, 90th, 95th, 97th, and 97.5th percentile values were: MCV (62.7, 63.6, 66.5, 69.6, 86.3, 87.7, 89.5, and 90.1fl), and MCH (19.0, 19.5, 20.8, 21.4, 28.2, 29.1, 29.5 and 29.7pg). The various calculated cut-off points for the MCV and MCH had lower sensitivity but a higher specificity for detecting iron deficiency than the standard reference values for the general population. The calculated cut-off point for the study subjects below the 10th percentiles had the best discriminatory performance. The cut-off for iron deficiency was 69.6fl for MCV and 21.4pg for MCH either use singly or in combination. In conclusion, standard reference cut-offs of MCV and MCH based on results from western individuals without sickle cell anaemia of the same age are not in agreement with the estimated values for children with sickle cell anaemia in Nigeria.

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 Discriminant Red Cell Indices for Microcytic Hypochromic Anaemia in Distinguishing Beta Thalassaemia Trait and Iron Deficiency Anaemia: A Systematic Review

2021 ◽  
Author(s):  
Ankita Sain ◽  
Arvind Bhake ◽  
Anil Agrawal ◽  
Sophia Thomas
Keyword(s):  
Systematic Review ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Red Cell ◽  
Diagnostic Reliability ◽  
Deficiency Anaemia ◽  
Beta Thalassaemia ◽  
Comparative Review ◽  
Thalassaemia Trait ◽  
Red Cell Indices

Introduction: Numerous red cell indices are in practice for surveillance of Microcytic Hypochromic (MCHC) anaemia in determination of their aetiology to the Iron Deficiency Anaemia (IDA) and Beta Thalassaemia Trait (BTT). The studies have revealed that there exists the discrepancies for Sensitivity (SN) and Specificity (SP) for any single index conclusive to classify them to the categories of IDA and BTT. A comparative review is needed as to know which index is suitable to discriminate between above two major entities under MCHC anaemia, which can be put to the practice in resource poor laboratories. Aim: A systematic review was planned for diagnostic reliability of red cell indices that segregates IDA from BTT in a morphological classification of MCHC anaemia. Materials and Methods: A systematic literature search was conducted in a database that yielded 36 studies dealing with one or more of the five included indices (Mentzer index, Bessman index, Green and King index, Srivastava index and Sirdah index) in the present analysis. The data for SN and SP of these indices were collected and compared from their performance at discrimination between IDA and BTT and Youden index was calculated to compare the performance of individual index. Results: Of these five indices, the comparative statistics has shown Green and King index works well at the SN of 79.37% and SP of 82.54% as compared to the rest of the indices. The second closest index that is practicable at discriminating IDA from BTT is Mentzer index. Conclusion: None of the indices can be completely relied upon to achieve a conclusive segregation. However, Green and King and Mentzer indices can be used for screening the suspected population to identify patients which may need the specialised tests to confirm the diagnosis to bring this population under proper treatment either for IDA or BTT.

Effect of Iron-deficiency Anæmia on the Metabolism of the Heterogenic Hæmoglobins in Sickle Cell Trait

Nature ◽  
1964 ◽  
Vol 202 (4931) ◽  
pp. 499-501 ◽  
Author(s):  
RICHARD D. LEVERE ◽  
HERBERT C. LICHTMAN ◽  
JOAN LEVINE
Keyword(s):  
Iron Deficiency ◽  
Sickle Cell ◽  
Iron Deficiency Anaemia ◽  
Sickle Cell Trait ◽  
Deficiency Anaemia

scholarly journals Intravenous versus oral iron therapy in treatment of postpartum anaemia

2017 ◽  
Vol 6 (8) ◽  
pp. 3454
Author(s):  
Neelima Agarwal ◽  
Preeti Sharma
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Ferrous Sulphate ◽  
Intravenous Iron ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
Chi Square ◽  
Deficiency Anaemia ◽  
Significant Difference ◽  
Red Cell Indices

Background: Postpartum iron deficiency anaemia (IDA) is common in women. Most women are treated with either oral iron supplementation or blood transfusion. Hence, the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA.Methods: 100 postpartum women with proven iron deficiency anaemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg, two to three doses given on alternate days (group 2). Total iron deficit was calculated using a standard formula. Target hemoglobin was 11 gm/dl. Results were analysed by the students t-test and chi-square test. Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartumResults: By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81±0.849 to 9.88±0.760 gm/dl which was more than those treated with oral iron (p<0.01); although by 6 weeks, there was no significant difference between the two groups. Ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.01).Conclusions: Intravenous iron sucrose increases the hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly. 

Reduced Frequency of Iron Deficiency Anaemia in Sickle Cell Trait

2009 ◽  
Vol 29 (4) ◽  
pp. 304-310 ◽  
Author(s):  
C. Hershko ◽  
J. Moreb ◽  
Y. Gaziel ◽  
A. M. Konijn ◽  
E. A. Rachmilewitz
Keyword(s):  
Iron Deficiency ◽  
Sickle Cell ◽  
Iron Deficiency Anaemia ◽  
Sickle Cell Trait ◽  
Deficiency Anaemia ◽  
Reduced Frequency

scholarly journals Iron stores in pregnant women with sickle cell disease: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026497 ◽  
Author(s):  
Desmond Aroke ◽  
Benjamin Momo Kadia ◽  
Tsi Njim
Keyword(s):  
Systematic Review ◽  
Sickle Cell Disease ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Iron Deficiency Anaemia ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Cell Disease ◽  
Deficiency Anaemia

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD have led to an increase in the number of women with SCD reaching the reproductive age. Iron deficiency anaemia remains the most common cause of anaemia in pregnancy, affecting 51%–63% of pregnancies in Africa. However, the unavailability of guidelines on supplementation of iron in this pregnant subpopulation often leaves clinicians in a fix. We propose to conduct the first systematic review and possibly a meta-analysis on the prevalence, associated factors and maternal/fetal outcomes of iron deficiency anaemia among pregnant women with SCD.Methods and analysisWe will search the following electronic databases for studies on the iron status of pregnant women with SCD: PubMed, MEDLINE, EMBASE, Google Scholar, African Journals Online, African Index Medicus, Popline and the Cochrane Library. After the selection of eligible studies from the search output, review of full text, data extraction and data synthesis will be performed. Studies obtained from the review shall be evaluated for quality, risk of bias and heterogeneity. Appropriate statistical methods shall be used to pool prevalence estimates for matching studies globally and in subpopulations. This protocol has been reported as per the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationThere is no requirement for ethical approval as the proposed study will use published data. The findings of this study will be published in a peer-reviewed journal and will be presented at conferences.Trial registration numberCRD42018109803.

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