Evaluation of the diagnostic reliability of different RBC indices and formulas in the differentiation of the β‐thalassaemia minor from iron deficiency in Palestinian population

International Journal of Laboratory Hematology - Tập 30 Số 4 - Trang 324-330 - 2008
Mahmoud M. Sirdah1, Issa S. Tarazi, Esmat Najjar, Rula Haddad
1Biology Department, Al Azhar University, Gaza, Palestine. [email protected]

Tóm tắt

Summaryβ‐thalassaemia minor and iron deficiency are the most common causes of microcytosis and/or hypochromasia. The present study evaluates the diagnostic reliability of different RBC indices and formulas, as well as our proposed formula, in the differentiation of the β‐thalassaemia minor from iron deficiency in Palestinian population. Complete blood count (CBC) parameters of 2196 certainly diagnosed (1272 β‐thalassaemia minor and 924 iron deficiency) samples were used to evaluate the following indices and formulas: Bessman index (RDW), Mentzer formula (MCV/RBC), England and Fraser formula (MCV − RBC − 5 × Hb − 3.4), Shine and Lal formula (MCV2 × MCH/100), Ehsani formula (MCV − 10 × RBC), Srivastava formula (MCH/RBC), Green and King formula (MCV2 × RDW/Hb × 100), red distribution width index RDWI (RDW × MCV/RBC), RDW/RBC, as well as our formula (MCV − RBC − 3 × Hb). For each index and formula, the receiver operative characteristic (ROC) curve was constructed to calculate the area under the curve (AUC), in addition, sensitivity, specificity, and likelihood ratios were calculated. No significant differences were reported between our formula, Green‐King formula and the RDWI (P > 0.05) in discriminating β‐thalassaemia minor from iron deficiency (AUC = 0.914, 0.909 and 0.907 respectively). However, the three indices and formula showed the highest efficiencies and they were significantly (P < 0.05) better than the others in the discrimination efficiency .It was concluded that our formula, Green–King formula and the RDWI provided the highest reliabilities in differentiating β‐thalassaemia minor from iron deficiency in Palestinian population while Bessman index was poor and ineffective for that purpose.

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Tài liệu tham khảo

Bentley S.A., 1989, The clinical utility of discriminant functions for the differential diagnosis of microcytic anemias, Blood Cells, 15, 575

10.1182/blood.V53.2.288.288

10.1093/ajcp/80.3.322

10.1046/j.1442-200X.2002.01636.x

Ehsani M., 2005, A new formula for differentiation of iron deficiency anemia (IDA) and thalassemia trait (TT), Turkish Journal of Haematology (Supplement), 22, 268

England J.M., 1989, Discriminant functions, Blood Cells, 5, 463

10.1016/S0140-6736(73)91878-3

Esposito N., 1992, Thalassemias : simple screening for hereditary anemias, Nurse Practice, 17, 50

Green R., 1989, A new red cell discriminant incorporating volume dispersion for differentiating iron deficiency anemia from thalassemia minor, Blood Cells, 15, 481

10.1007/BF02598003

10.1093/ajcp/106.2.201

10.1016/S0140-6736(73)91446-3

D’Onofrio G., 1992, Automated measurement of red blood cell microcytosis and hypochromia in iron deficiency and beta‐thalassemia trait, Archives of Pathology and Laboratory Medicine, 116, 84

10.1007/BF00443100

Ricerca B.M., 1987, Differentiation of iron deficiency from thalassemia trait: a new approach, Haematologica, 72, 409

10.1002/ajh.2830390102

Rund D., 1992, Mean corpuscular volume of heterozygotes for beta ‐thalassemia correlates with the severity of mutations, Blood, 79, 238, 10.1182/blood.V79.1.238.238

10.1016/S0140-6736(77)92128-6

10.1016/S0140-6736(73)90637-5

10.1111/j.1751-553X.2006.00836.x

Weatherall D., 1996, Oxford Textbook of Medicine, 3500

Thông tin
Thông tin xuất bản

International Journal of Laboratory Hematology

Tập 30 Số 4

324-330

Thông tin tác giả