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.

Reticulocyte parameters of delta beta thalassaemia trait, beta thalassaemia trait and iron deficiency anaemia

2015 ◽  
Vol 69 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Diego Velasco-Rodríguez ◽  
Juan-Manuel Alonso-Domínguez ◽  
Fernando-Ataúlfo González-Fernández ◽  
Jesús Villarrubia ◽  
María Sopeña ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anaemia ◽  
Beta Thalassaemia ◽  
Thalassaemia Trait

scholarly journals Study of blood indices and high performance liquid chromatography (HPLC) in differentiation of β-thalassemia trait and iron deficiency anaemia

2017 ◽  
Vol 5 (11) ◽  
pp. 4728 ◽  
Author(s):  
Pravin M. Meshram ◽  
Hemant R. Kokandakar ◽  
Rajan S. Bindu
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Deficiency Anaemia ◽  
Beta Thalassaemia ◽  
Thalassaemia Trait ◽  
Patient Groups ◽  
Thalassemia Trait

Background: Iron deficiency anemia (IDA) and beta thalassaemia trait (BTT) are two of the most common causes of microcytic anemia.It is essential to differentiate between the two, so as to avoid unnecessary iron therapy which is contraindicated in beta thalassaemia .We retrospectively evaluated the reliability of various indices for differential diagnosis of microcytosis and 𝛽-TT in the same patient groups .Methods: A total of 200 patients were evaluated. We calculated 6 discrimination indices in all patients with anemia or suspected beta thalassemia. None of the subjects had  combined  IDA and 𝛽-TT. The patient groups were evaluated according to  the Mentzer, Shine and Lal, England and Fraser,Srivastava, Green and King, Ricerca.Results: According to percentage correctly diagnosed criteria, Ricerca  and Mentzer  index are considered as the two best discrimination indices in differentiation between β thalassemia trait  and iron deficiency anaemia .Youden’s index showed the following ranking with respect to the indices’ ability to distinguish between 𝛽-TT and IDA, Ricerca index >  Mentzer index > Green and King index >  Srivastava index >  Shine and Lal index > England and Fraser index.Conclusions: Ricerca  and Mentzer  index are considered as the two best discrimination indices in differentiation between β thalassemia trait  and iron deficiency anaemia.Keywords: Iron deficiency anemia (IDA) and beta thalassaemia trait (𝛽-TT) 

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 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 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.

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