The Effect of Iron Deficiency Anemia ( IDA) on the HbA2 Level and Comparison of Hematologic Values Between IDA and Thalassemia Minor

The most common hypochrom microcytic anemia are iron deficiency anemia (IDA) and thalassemia minor (TM). The results of some studies have shown that IDA can cause misdiagnosis of heterozygote β-thalassemia due to decrease in HbA2 level. Our aim in this study was evaluating the effect of IDA on HbA2 levels; Furthermore hematolagic values in CBC of these two diseases will be compared. In this study 291 individuals including normal control group, heterozygote α and β-thalassemia minor, IDA and coincident β-thalassemia and IDA patients were under investigation. CBC, serum ferritin, iron, and TIBC levels and hemoglobin electrophoresis in alkaline PH was managed for every subjects. They were then put into groups according to diagnostic criteria and were analyzed applying SPSS software (version 11.5) and statistical tests especially ttest. HbA2 levels were 2.9%±0.4 in normal group, 2.7%±0.6 in IDA patients, 5.6%±0.9 in β-thalassemia minor, 4.7%±1 in coincident IDA and β-thalassemia minor. Above mentioned significant differences in HbA2 values are between normal and IDA individuals, also between β-thalassemia minor and coincident β-thalassemia and IDA patients. RBC counts, Hb, Hct, MCH, MCHC values were significantly higher in bthalassemia minor comparing with IDA patients but MCV showed no significant difference in these two groups. RDW was increased in both, but it was higher in IDA. IDA can cause a decrease in HbA2 level. This point sometimes leads misdiagnosis particularly in coincident IDA and β-thalassemia minor. Therefore in suspicious cases of β-thalassemia trait in IDA background, it is better to do hemoglobin electrophoresis after treatment of IDA.