Confirmation of the validity of using birth MCV for the diagnosis of alpha thalassemia trait

Thirty-four blood samples of neonates in Dubai, UAE, with an MCV below 90 fL were checked by high performance liquid chromatography (HPLC) for hemoglobin variants to confirm a previous study carried out in Western Province of Saudi Arabia which showed a very high predictive index of such MCV for alpha (α-) thalassemia minor (ATM). MCH below 30 pg was an additional factor which supported such a prediction. The Dubai study confirmed the original finding with 100% of such neonates showing Hb Barts band. A control group of 26 neonates with an MCV between 90 and 95 fl showed Hb Barts in only 11 cases (42.3%). Of these, 6 (23.1%) were preterm babies, expected to have higher MCV. Five cases (19.2%) had an MCH below 30 pg, though MCV was 90 or higher. Three of the preterm babies also had MCH below 30. The study confirmed the Saudi results in neonates. It seems very highly probable that a term neonate with MCV below 90 and MCH below 30 has ATM.