A new index to discriminate between iron deficiency anemia and thalassemia trait

Matos, Januária Fonseca; Dusse, Luci Maria S.; Borges, Karina Braga Gomes; Castro, Ricardo L.V. de; Coura‐Vital, Wendel; Carvalho, Maria das Graças

doi:10.1016/j.bjhh.2016.05.011

Cited by 55 publications

(57 citation statements)

References 16 publications

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“…The Youden's index considers both sensitivity and specificity and provides an appropriate measure of the overall validity of the index or technique [23]. Matos et al, [6] reported that its sensitivity was 99.3%, Specificity 76.7% and YI was 76.0%, and the evaluation of this index by Arora et al, [22] showed high sensitivity to detect IDA (98.81%), excellent diagnostic accuracy and showing good applicability as screening tool in clinical practice. On the other hand Sirdah et al, [5] [25].…”

Section: Discussionmentioning

confidence: 99%

“…These confirmatory tests could be limited for mass screening programs, due to financial causes, especially in developing and poor countries with restricted resources [4] [5]. The development of indices with good diagnostic accuracy based on parameters derived from the blood cell counters would be useful in the clinical routine [6]. Accurate diagnosis of hypochromic microcytic anemia is an everyday concern for physicians; for appropriate treatment and prevention of disease [7].…”

Section: Introductionmentioning

confidence: 99%

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Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Hamed¹,

El-Deen²

2019

OJBD

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Background: The most common causes of microcytic hypochromic anemia are iron deficiency anemia (IDA) and the beta-thalassemia trait (β-TT). The aim of the work is to compare the validity of the various simple indices to differentiate between iron deficiency anemia and β-thalassemia trait. Subjects and methods: A total of 2000 individuals were screened, by complete blood picture, measurement of serum iron, serum ferritin and hemoglobin separation; 224 patients were detected as having hypochromia and microcytosis.Among them 166 cases were IDA and 58 cases were β-TT. We calculated 11 discrimination indices. The number of correctly identified cases were determined, sensitivity, specificity, positive and negative predictive value and Youden's index (YI) of each discrimination index was calculated. Results: The percentage of correctly diagnosed patients is highest for Matos and Carvalho index (MCI) (95.5%) which is closely followed by Red cell distribution width index (RDWI) (93.7%). The third high index was Green and King (GKI) (91.9%). Sensitivity, specificity of MCI for detection of IDA was found 98.8%, 87.9% respectively. For β-TT, sensitivity and specificity was found 86.2% and 98.8% respectively. The YI of MCI was found 85.9%. It is followed by RDWI; its sensitivity and specificity for detection of IDA was found 97.6%, 85.3%. For β-TT, sensitivity and specificity was found 82.7% and 97.6% respectively. The YI of RDWI was 81.6%. Conclusion: Matos and Carvalho index and RDWI are easily available automated cell-count-based indices coming out as good discriminator between IDA and β-TT in our study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Hamed¹,

El-Deen²

2019

OJBD

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“…Other data suggest that MicroR could be of potential interest to detect beta‐thalassemia minor in patients, but a ROC curve analysis supports MCV to be a better marker (respectively, AUC = 0.89 and 0.92, Figure ). MicroR/%HypoHe ratio is not accurately enough to discriminate beta‐thalassemia minor and iron deficiency, and an index of multiple parameters has been specifically described to this attend with various results …”

Section: Discussionmentioning

confidence: 99%

“…MicroR/%HypoHe ratio is not accurately enough to discriminate beta-thalassemia minor and iron deficiency, and an index of multiple parameters has been specifically described to this attend with various results. 17,18 To conclude, we propose a costless, easy-to-use screening approach highly efficient to detect HS and pyruvate kinase deficiencies using Sysmex analyzers. These screening tools produce substantially better results than using only one parameter (Tables S2 and S3).…”

Section: Discussionmentioning

confidence: 99%

Screening of hereditary spherocytosis and pyruvate kinase deficiency by automated blood count using erythrocytic and reticulocytic parameters

Bobée

Daliphard

Schrapp

et al. 2018

Int J Lab Hematology

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“…Serum iron and ferritin dosages are good indicators of iron storage, enabling the early detection of iron deficiency. Nonetheless, in cases where ferritin levels are within the reference values or increased, other tests such as total iron binding capacity and transferrin saturation may help in better characterization of the type of anemia [30,31].…”

Section: Resultsmentioning

confidence: 99%

Deletional Alpha-Thalassemia Alleles in Amazon Blood Donors

Anselmo

Ferreira

Mota

et al. 2020

Advances in Hematology

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Alpha-thalassemia is highly prevalent in the plural society of Brazil and is a public health problem. There is limited knowledge on its accurate frequency and distribution in the Amazon region. Knowing the frequency of thalassemia and the prevalence of responsible mutations is, therefore, an important step in the understanding and control program. Hematological and molecular data, in addition to serum iron and serum ferritin, from 989 unrelated first-time blood donors from Amazonas Hemotherapy and Hematology Foundation (FHEMOAM) were collected. In this study, the subjects were screened for −α3.7/4.2/20.5, −SEA, −FIL, and −MED deletions. Alpha-thalassemia screening was carried out between 2016 and 2017 among 714 (72.1%) male and 275 (27.9%) female donors. The aims of this analysis were to describe the distribution of various alpha-thalassemia alleles by gender, along with their genotypic interactions, and to illustrate the hematological changes associated with each phenotype. Amongst the patients, 5.35% (n = 53) were diagnosed with deletion –α−3.7 and only one donor with α−4.2 deletion. From the individuals with –α−3.7, 85.8% (n = 46) were heterozygous and 14.20% (n = 7) were homozygous. The frequency of the –α−3.7 deletion was higher in male (5.89%) than in female (4.0%). There is no significant difference in the distribution of –α−3.7 by gender (p=0.217). The –α20.5, −SEA, and −MED deletions were not found. All subjects were analyzed for serum iron and serum ferritin, with 1.04% being iron deficient (n = 5) and none with very high levels of stored iron (>220 µg/dL). Alpha-thalassemia-23.7kb deletion was the most common allele detected in Manaus blood donors, which is a consistent result, once it is the most common type of α-thalassemia found throughout the world. As expected, the mean of hematological data was significantly lower in alpha-thalassemia carriers (p<0.001), mainly homozygous genotype. Leukocytes and platelet count did not differ significantly. Due to the small number of individuals with iron deficiency found among blood donors, the differential diagnosis between the two types of anemia was not possible, even because minor changes were found among hematological parameters with iron deficiency and α-thalassemia. Despite this, the study showed the values of hematological parameters, especially MCV and MCH, are lower in donors with iron deficiency, especially when associated with α-thalassemia, and therefore, it may be useful to discriminate different types of microcytic anaemia. In conclusion, we believed screening for thalassemia trait should be included as part of a standard blood testing before blood donation. It should be noted that this was the first study to perform the screening for alpha deletions in blood donors from the Manaus region, and further studies are required to look at the effects of donated thalassemic blood.

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A new index to discriminate between iron deficiency anemia and thalassemia trait

Cited by 55 publications

References 16 publications

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Simple Red Cell Indices in Screening and Discrimination of Iron Deficiency Anemia and Beta Thalassemia Trait in Egyptian Patients

Screening of hereditary spherocytosis and pyruvate kinase deficiency by automated blood count using erythrocytic and reticulocytic parameters

Deletional Alpha-Thalassemia Alleles in Amazon Blood Donors

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