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

Abstract

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)

Role of Hematological Indices as a Screening Tool of Beta Thalassemia Trait in Eastern Uttar Pradesh: An Institutional Study

“…Ricerca Index and Shine and Lal Index were found to have the highest sensitivity in our study (100%) for differentiating BTT from iron deficiency anemia. This finding was similar to the Indian studies done by Singh et al [9], Rathod et al [10], Bhushan et al [3], Meshram et al [5] and Mukhopadhyay et al [11]. Our findings were also concordant with studies by Vehapoglu et al [6], Demir et al [12], Chuan et al [7] and Okan et al [13].…”

“…Green and King Index showed results of YI comparable to Sirdah et al [2], Okan et al [13], Ntaois et al [15], Chuan et al [7] and Demir et al [12]. A lower value ranging from 30 to 60% was observed by the other studies [3,5,11,14].…”

“…For Ricerca Index, Meshram et al [5] observed a slightly higher but similar Youden's Index while majority of the studies showed a lower value ranging between 50 and 70% [2,7,8,13,14]. YI as low as 14.7% and 29.6% was also observed by Vehapoglu et al [6] and Rathod et al [10] respectively.…”

“…For MI, Niazi et al [8], Okan et al [13], Suad et al [14] and Sirdah et al [2] observed results similar to the present study. A higher Youden's Index of 92%, 90.1% and 8% was observed by Rathod et al [10], Ehsani et al [16] and Vehapoglu et al [6] respectively; while the other studies demonstrated a lower value ranging between 48 and 58% [5,7,11,12,15].…”