Evaluation of Two Hematologic Indices and Extrapolated HbA2 Values in the Differential Diagnosis of Iron Deficiency Anemia (IDA) and Beta Thalessemia Traits with IDA

We evaluated the combination of two indices of red blood cell count (RBC) and red blood cell distribution with index (RDWI) and extrapolated HbA2 values in differential diagnosis of iron deficiency anemia (IDA) and beta-thalassemia traits (BTT) associated with IDA. A total 129 subjects were included in this study. RBC/RDWI was able to diagnose 32% beta-thalassemia with iron deficiency while 66% had IDA. HbA2 showed beta-thalassemia cases accounted 48% of the total, while IDA accounted 52%, giving RBC/RDWI approach of diagnosing BTT/IDA vs. IDA sensitivity rate of 77% and specificity rate 100% in diagnosing BTT; whereas it had sensitivity rate 76% and specificity rate 77% in diagnosing IDA. HbA2 considered as gold standard, sensitivity of RBC/RDWI approach 100% and specificity 95% in diagnosing BTT while IDA, sensitivity 95% and specificity 100%. RBC/RDWI in diagnosing BTT and IDA seems to be an effective tool. As hemoglobin electrophoresis still standard in this respect, decisions based on this recommended approach plus extrapolating HbA2 values may circumvent problem of long waiting time, particularly in situations where rendering of the most probable diagnosis at shortest time.