Usefulness of Cell Counter-Based Parameters and Formulas in Detection of β-Thalassemia Trait in Areas of High Prevalence
Dinesh A. Rathod,Amarjeet Kaur,Vinod Patel,Kunjal Patel,Raviraj Kabrawala,Viral Patel,Mohak Patel,Pranay Shah +7 more
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TLDR
It is found that the Shine and Lal, Srivastava, and Mentzler indexes, MCV, and MCH have better discriminative function than the RBC count and red cell distribution width and their related formulas.Abstract:
The present study aimed to retrospectively evaluate the usefulness of cell counter–based parameters and formulas in β-thalassemia trait (BTT) detection. The study included 170 BTT cases (hemoglobin [Hb]A 2 >4.0% [0.04]) and 30 non-BTT cases (HbA 2 , 2.3%3.5% [0.02-0.04]). Depending on the hemoglobin level and iron deficiency, the BTT group was further classified into classic BTT (n = 112) and BTT with iron deficiency anemia (n = 58). The RBC count, MCH, MCV, RDW, and Shine and Lal, Mentzler, Srivastava, England and Fraser, Ricerca, and Green indexes were applied. For the first time in the population of India, these 10 cell counter parameters and manual formulas were compared with high-performance liquid chromatography–derived HbA 2 levels for deriving a cost-effective alternative method; and receiver operating characteristic curves were applied. We found that the Shine and Lal, Srivastava, and Mentzler indexes, MCV, and MCH have better discriminative function than the RBC count and red cell distribution width and their related formulas. Thalassemia is a genetic disorder affecting synthesis of the globin moiety of the hemoglobin molecule. β-Thalassemia is prevalent in a broad belt extending from the Mediterranean basin to Southeast Asia. It is estimated that 1.5% of the world’s population carries β-thalassemia, ie, at least 80 to 90 million people with an estimated 60,000 new carriers born each year. The Southeast Asian region (which includes India, Thailand, and Indonesia) accounts for about 50% of the world’s carriers, ie, around 40 million people and almost half of homozygous births, whereas in the developed world, Europe and the Americas jointly account for just 10% to 13% of the world’s carriers. 1 The prevalence of β-thalassemia trait (BTT) is about 3.3% in India. In various parts of India, the prevalence of BTT is different: 6.5% in Punjab, 8.4% in Tamilnadu, 4.3% in south India, and 3.5% in Bengal. βThalassemia has a high prevalence in some communities, such as Sindhi, Luvana, Tribes, and Rajputs. The incidence of BTT in Gujarat is 10% to 15% in these communities, whereas the incidence in the general population is 2% to 3%. 2 Because a majority of people with BTT are asymptomatic, they may not be aware of their carrier state. BTT is associated with mild or no anemia but with reduced mean corpuscular volume (MCV) mean corpuscular hemoglobin (MCH) values and an elevated hemoglobin A 2 (HbA 2 ) level. The prevention of this homozygous condition can beread more
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Hematological indices for differential diagnosis of Beta thalassemia trait and iron deficiency anemia.
Aysel Vehapoglu,Gamze Ozgurhan,Aysegul Dogan Demir,Selcuk Uzuner,Mustafa Atilla Nursoy,Serdar Turkmen,Arzu Kacan +6 more
TL;DR: The Mentzer index was the most reliable index, as it had the highest sensitivity, specificity, and Youden's index for detecting β-TT for detecting IDA and this was followed by the Ehsani index.
Journal ArticleDOI
Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a reply
TL;DR: The ratio of microcytic to hypochromic RBCs (M/H ratio) showed the best performance and outperformed all other discriminant indices for discriminating between iron deficiency anemia and thalassemia trait.
Journal ArticleDOI
The role of automated measurement of RBC subpopulations in differential diagnosis of microcytic anemia and β-thalassemia screening.
TL;DR: The % microcytic - % hypochromic - RDW was the most reliable index evaluated, with 100% sensitivity and 92.6% specificity, and can be used to efficiently screen patients with microcytosis for further hematologic studies to confirm β-thalassemia.
Journal ArticleDOI
Discriminant value of % microcytic/% hypochromic ratio in the differential diagnosis of microcytic anemia.
TL;DR: This index, with high sensitivity for β thalassemia screening, can be a useful tool in the differential diagnosis of microcytic anemia, so samples can be chosen for HbA2 analysis, to confirm the presumptive diagnosis of the disease.
Journal ArticleDOI
Anemia in tuberculosis cases and household controls from Tanzania: contribution of disease, coinfections, and the role of hepcidin
Jerry Hella,Colin I. Cercamondi,Francis Mhimbira,Francis Mhimbira,Francis Mhimbira,Mohamed Sasamalo,Mohamed Sasamalo,Mohamed Sasamalo,Nicole U. Stoffel,Marcel Zwahlen,Thomas Bodmer,Sebastien Gagneux,Klaus Reither,Klaus Reither,Michael B. Zimmermann,Lorenz Risch,Lukas Fenner +16 more
TL;DR: Increased hepcidin levels long before active disease, indicating altered iron metabolism, may be a marker for developing disease among TB-exposed individuals.
References
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Book
Clinical guide to laboratory tests
TL;DR: This guide to laboratory tests describes the different types of tests that can be carried out in the laboratory and some of the techniques used to perform these tests are straightforward to use.
Journal ArticleDOI
Differentiation of iron deficiency from thalassaemia trait by routine blood-count.
J.M. England,PatriciaM. Fraser +1 more
TL;DR: In 72 patients presenting with microcytosis, a simple discriminant function derived from the mean cell volume and the haemoglobin concentration correctly identified all but one of the cases studied (99%).
Journal Article
A new red cell discriminant incorporating volume dispersion for differentiating iron deficiency anemia from thalassemia minor.
Ralph Green,R. King +1 more
TL;DR: It was concluded that use of a discriminant function that incorporates a measurement of red cell volume dispersion results in enhanced accuracy for distinguishing iron deficiency anemia from thalassemia minor.
Journal ArticleDOI
A strategy to detect β-thalassaemia minor.
Ian Shine,S. Lal +1 more
TL;DR: The best methods of detecting β-thalassaemia minor using red-blood-cell indices were compared and a new method was devised consisting of haemoglobin electrophoresis.