Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia

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 ca...

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Main Authors: Aysel Vehapoglu, Gamze Ozgurhan, Ayşegul Dogan Demir, Selcuk Uzuner, Mustafa Atilla Nursoy, Serdar Turkmen, Arzu Kacan
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Anemia
Online Access:http://dx.doi.org/10.1155/2014/576738
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author Aysel Vehapoglu
Gamze Ozgurhan
Ayşegul Dogan Demir
Selcuk Uzuner
Mustafa Atilla Nursoy
Serdar Turkmen
Arzu Kacan
author_facet Aysel Vehapoglu
Gamze Ozgurhan
Ayşegul Dogan Demir
Selcuk Uzuner
Mustafa Atilla Nursoy
Serdar Turkmen
Arzu Kacan
author_sort Aysel Vehapoglu
collection DOAJ
description 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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spelling doaj-art-6a2008ca41b14806a726d131e79a7f3e2025-08-20T03:33:39ZengWileyAnemia2090-12672090-12752014-01-01201410.1155/2014/576738576738Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency AnemiaAysel Vehapoglu0Gamze Ozgurhan1Ayşegul Dogan Demir2Selcuk Uzuner3Mustafa Atilla Nursoy4Serdar Turkmen5Arzu Kacan6Department of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, TurkeyDepartment of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, 34010 Istanbul, TurkeyDepartment of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, TurkeyDepartment of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, TurkeyDepartment of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, TurkeyDepartment of Biochemistry, Istanbul Training and Research Hospital, 34098 Istanbul, TurkeyDepartment of Pediatrics, Istanbul Training and Research Hospital, Istanbul, TurkeyBackground. 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.http://dx.doi.org/10.1155/2014/576738
spellingShingle Aysel Vehapoglu
Gamze Ozgurhan
Ayşegul Dogan Demir
Selcuk Uzuner
Mustafa Atilla Nursoy
Serdar Turkmen
Arzu Kacan
Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia
Anemia
title Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia
title_full Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia
title_fullStr Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia
title_full_unstemmed Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia
title_short Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia
title_sort hematological indices for differential diagnosis of beta thalassemia trait and iron deficiency anemia
url http://dx.doi.org/10.1155/2014/576738
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