Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait Demir eksikliği anemisinin beta-talasemi taşıyıcılığından ayırıcı tanısının daha iyi yapılması
نویسندگان
چکیده
Objective: Iron deficiency anemia (IDA) and beta-thalassemia trait (ß-TT) are the most common forms of microcytic anemia. This study was conducted to compare the validity of various discrimination indices in differentiating β-TT from IDA by calculating their sensitivity, specificity and Youden's index. Methods: Totally 323 subjects (173 children and 150 adults) 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 or older than 10 years. Results: None of the indices showed sensitivity and specificity of 100% in the patients older than 10 years, and in the patients younger than 10 years, only Shine & Lal index showed sensitivity close to 90% and specificity of 100%. The most accurate discriminative index for patients younger than 10 years was Shine & Lal and for those older than 10 years it was RDW index. According to Youden's index, Shine & Lal and RBC count showed the greatest diagnostic value in patients younger than 10 years and RDW and RBC count indices in those older than 10 years. Conclusion: None of the indices was completely sensitive and specific in differentiation between β-TT and IDA. Mean and median mean cell Hb density (MCHD) were very close to normal values in both IDA and β-TT patients, but in the case of mean density of Hb/liter (MDHL), we found that the mean and median were significantly higher than normal values in β-TT and lower than normal values in IDA patients. In our study, Youden's index of RBC and Shine & Lal were the highest and most reliable indices in differentiating β-TT from IDA in the patients younger than 10 years. For patients older than 10 years, the most reliable discrimination indices were RBC and RDW. (Turk J Hematol 2009; 26: 138-45)
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Evaluation of Twenty Four Discriminant Indices for Differentiating Beta-Thalassemia Trait from Iron Deficiency Anemia in Egyptians
Background: Many Red Blood Cell (RBC) indices have been developed based on mathematical formulae to discriminate beta-thalassemia trait (βTT) from iron deficiency anemia (IDA). The latter two conditions represent the most common causes of microcytic hypochromic anemia in Egypt. This study aimed To evaluate the diagnostic reliability of 24 published discriminant indices for differentiating βTT f...
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