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Anemia. 2014;2014:576738. doi: 10.1155/2014/576738. Epub 2014 Apr 10.

Hematological indices for differential diagnosis of Beta thalassemia trait and iron deficiency anemia.

Author information

1
Department of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, Turkey.
2
Department of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, 34010 Istanbul, Turkey.
3
Department of Biochemistry, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
4
Department of Pediatrics, Istanbul Training and Research Hospital, Istanbul, Turkey.

Abstract

BACKGROUND:

The two most frequent types of microcytic anemia are beta thalassemia trait ( β -TT) and iron deficiency anemia (IDA). 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 290 carefully selected children aged 1.1-16 years were evaluated. We calculated 12 discrimination indices in all patients with hemoglobin (Hb) values of 8.7-11.4 g/dL. None of the subjects had a combined case of IDA and β -TT. All children with IDA received oral iron for 16 weeks, and HbA2 screening was performed after iron therapy. The patient groups were evaluated according to red blood cell (RBC) count; red blood distribution width index; the Mentzer, Shine and Lal, England and Fraser, Srivastava and Bevington, Green and King, Ricerca, Sirdah, and Ehsani indices; mean density of hemoglobin/liter of blood; and mean cell density of hemoglobin.

RESULTS:

The Mentzer index was the most reliable index, as it had the highest sensitivity (98.7%), specificity (82.3%), and Youden's index (81%) for detecting β -TT; this was followed by the Ehsani index (94.8%, 73.5%, and 68.3%, resp.) and RBC count (94.8%, 70.5%, and 65.3%).

CONCLUSION:

The Mentzer index provided the highest reliabilities for differentiating β -TT from IDA.

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