Better differential diagnosis of iron deficiencyanemia from beta-thalassemia trait

Rahim, Fakher; Keikhaei, Bijan

Better differential diagnosis of iron deficiencyanemia from beta-thalassemia trait [Turk J Hematol]

Turk J Hematol. 2009; 26(3): 138-145

Better differential diagnosis of iron deficiencyanemia from beta-thalassemia trait

Fakher Rahim¹, Bijan Keikhaei²
¹Research Center Of Thalassemia & Hemoglobinopathies, Ahwaz Jondishapour University Of Medical Sciences And
²Physiology Research Center, Ahwaz Jondishapour University Of Medical Sciences, Ahwaz, Iran

OBJECTIVE: Iron deficiency anemia (IDA) and �- Thalassemia Trait (�-TT) are the most common forms of microcytic anemia. This study was conducted to compare the validity of these discrimination indices in differentiating �- Thalassemia Trait (β-TT) from IDA by calculating their sensitivity, specificity and Youden's index.
METHODS: Totally 323 subjects (173 children and 150 adult) with microcytic anemia were involved in this study. We calculated 10 discrimination indices in all patients with IDA and β-TT. We divided the patients into two different groups as younger and older than 10 years.
RESULTS: None of indices showed sensitivity and specificity of 100% in the patients older than 11 years, but only Shine and Lal Index showed sensitivity close to 90% and specificity of 100% in the patients younger than 10 years. The most accurate discriminative index for patients younger than 10 years was Shine & Lal and in case of patients older than 11 years it was RDWI. Youden's index for Shine & Lal & RBC Count and for RDWI & RBC Count indices has most diagnostic value for younger and older than 10 years, respectively.
CONCLUSION: None of the indices was completely sensitive and specific in differentiation between β-TT and IDA. MCHD mean and median were very close to normal values for both IDA and β-TT patients, but in case of MHDL we have found mean and median were significantly higher than normal values in β-TT and lower than those in IDA patients. In our study, Youden's index of RBC and S & L were the highest and the most reliable discrimination indices in differentiating β-TT from IDA in the patients younger than 10 years and for patients older than 11 years, the most reliable discrimination indices were RBC and RDWI.

Keywords: �-Thalassemia trait, iron deficiency anemia, red blood cell, indices, discriminative indices

Demir eksikli�i anemisinin beta-talasemi ta��y�c�l��ndan ay�r�c� tan�s�n�n daha iyi yap�lmas�

AMA�: Demir eksikli�i anemisi (DEA) ve beta-talasemi ta��y�c�l��, mikrositik aneminin en s�k nedenleridir. Bu �al��ma, β-talasemi ta��y�c�l��n�n (β-TT) DEA�dan ayr�m�nda kullan�lan ay�rt edici indekslerin duyarl�l�klar�n�, �zg�ll�klerini ve Youden indekslerini hesaplayarak, ay�r�c� tan�daki �nemlerini kar��la�t�rmak amac�yla y�r�t�lm��t�r.
Y�NTEMLER: Mikrositik anemili toplam 323 ki�i (173 �ocuk ve 150 eri�kin) bu �al��maya dahil edilmi�tir. DEA ve β-TT�li t�m hastalarda 10 ay�rt edici indeks de�erlendirilmi�tir. Hastalar 10 ya��ndan k��k ve 10 ya��ndan b�y�k olmak �zere iki farkl� gruba ayr�lm��t�r.
BULGULAR: �ndekslerden hi�biri 11 ya��ndan b�y�k hastalarda %100 duyarl�l�k ve �zg�ll�k g�stermemi�, sadece Shine ve Lal indeksleri 10 ya��ndan k��k hastalarda %90�a yak�n bir duyarl�l�k ve %100 �zg�ll�k g�stermi�tir. En hassas ay�rt edici indeks olarak 10 ya��ndan k��k hastalar i�in Shine ve Lal indeksleri, 11 ya��ndan b�y�k hastalar i�in ise RDWI indeksi bulunmu�tur. Shine ve Lal ve k�rm�z� kan h�cresi say�s� i�in Youden indeksinin ve RDWI ve k�rm�z� kan h�cresi say�s� i�in Youden indeksinin, s�ras�yla 10 ya��ndan k��k ve 10 ya��ndan b�y�k hastalar i�in en y�ksek tan�sal de�ere sahip oldu�u
g�r�lm��t�r.
SONU�: �ndekslerden hi�biri β-TT ve DEA ayr�m�nda tam olarak duyarl� ve �zg�l de�ildi. Hem DEA hem de β-TT hastalar� i�in ortalama ve ortanca MCHD de�erleri normale �ok yak�nd�, fakat MHDL durumunda ortalama ve ortancalar�n, β-TT i�in normal de�erlerden anlaml� olarak y�ksek ve EDA hastalar�n�n de�erlerlerinden d��k oldu�unu bulduk. �al��mam�zda, Shine ve Lal ve k�rm�z� kan h�cresi say�s�n�n Youden indeksi 10 ya��ndan k��k hastalarda β-TT ve DEA ayr�m�nda en y�ksek ve en g�venilir ay�rt edici indeks, 11 ya��ndan b�y�k hastalar i�in ise k�rm�z� kan h�cresi ve RDWI en g�venilir indeksler olarak bulunmu�tur.

Anahtar Kelimeler: β, -talasemi ta��y�c�l��, demir eksikli�i anemisi, k�rm�z� kan h�cresi, �ndeksler, ay�r�c� indeksler

Fakher Rahim, Bijan Keikhaei. Better differential diagnosis of iron deficiencyanemia from beta-thalassemia trait. Turk J Hematol. 2009; 26(3): 138-145

Corresponding Author: Fakher Rahim, Iran

TOOLS

Full Text PDF

Download citation

RIS

EndNote

BibTex

Medlars

Procite

Reference Manager

Share with email

Send email to author

Similar articles

PubMed

Google Scholar

In authors and institutes

In titles and abstracts

In keywords

In all


	E-ISSN: 1308-5263
Archive Most Accessed Articles Most Cited Articles Aims and Scope Instructions For Authors Editorial Board Advisory Board Manuscript Submission Why to Submit Search Contact

Better differential diagnosis of iron deficiencyanemia from beta-thalassemia trait

Demir eksikli�i anemisinin beta-talasemi ta��y�c�l���ndan ay�r�c� tan�s�n�n daha iyi yap�lmas�

Demir eksikli�i anemisinin beta-talasemi ta��y�c�l��ndan ay�r�c� tan�s�n�n daha iyi yap�lmas�