Discriminant Functions In Distinguishing Beta Thalassemia Trait and Iron Deficiency Anemia: The value of the RDW-SD

10.5580/1b99 ◽  
2011 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Discriminant Functions ◽  
Thalassemia Trait

scholarly journals The role of discriminant functions in screening beta thalassemia trait and iron deficiency anemia among laboratory samples

2017 ◽  
Vol 9 (03) ◽  
pp. 195-201 ◽  
Author(s):  
Ashwani Kumar ◽  
Debarshi Saha ◽  
Jyoti Kini ◽  
Nirupama Murali ◽  
Shrijeet Chakraborti ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Youden Index ◽  
Beta Thalassemia ◽  
Red Cell ◽  
Discriminant Functions ◽  
Distribution Width ◽  
Sample Distribution ◽  
Thalassemia Trait

Abstract INTRODUCTION: Most important differential diagnosis for microcytosis and hypochromia is beta thalassemia trait (BTT) and iron deficiency anemia. AIM: To study the utility of discriminant functions (DFs) and red cell indices in distinguishing BTT and iron deficiency anemia. METHODS: The study is observational (cross sectional). A total of 350 patients, 43 BTT, and 307 iron-deficiency anemia reflecting actual disease prevalence were included. Their complete red blood cell parameters, hemoglobin A2, and serum ferritin level wherever required were obtained. Receiver operator characteristic curve was drawn for each DF and results compared with other studies. RESULTS: Among the six DFs, the highest sensitivity (97.7%) and specificity (98.6%) was shown, respectively, by Shine and Lal (S and L) and England and Fraser index (E and F) in identifying cases of BTT. Youden index of the Mentzer index (MI) was the highest (69.0) and S and L, the lowest (13.2) indicating MI to be the most efficient and the S and L, the least in differentiating the two entities. Red cell distribution width index (RDWI) showed the highest accuracy (91.6%), whereas S and L showed the least accuracy (29.6%). CONCLUSION: MI was the most efficient in discriminating BTT from iron deficiency anemia (IDA). RDWI stands to be the most accurate. S and L could at best be used as screening tool rather than DF. No study except one agreed with us because convenient sampling used in other studies generated bias in their results. Statistically, this study bears far more relevance than other studies because the sample distribution reflects the prevalence of IDA and BTT in the community.

scholarly journals Application of Bayesian Decision Tree in Hematology Research: Differential Diagnosis of β-Thalassemia Trait from Iron Deficiency Anemia

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Mina Jahangiri ◽  
Fakher Rahim ◽  
Najmaldin Saki ◽  
Amal Saki Malehi
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Hematological Parameters ◽  
False Positive Rate ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Bayesian Tree ◽  
Thalassemia Trait ◽  
Cart Algorithm

Objective. Several discriminating techniques have been proposed to discriminate between β-thalassemia trait (βTT) and iron deficiency anemia (IDA). These discrimination techniques are essential clinically, but they are challenging and typically difficult. This study is the first application of the Bayesian tree-based method for differential diagnosis of βTT from IDA. Method. This cross-sectional study included 907 patients with ages over 18 years old and a mean (±SD) age of 25 ± 16.1 with either βTT or IDA. Hematological parameters were measured using a Sysmex KX-21 automated hematology analyzer. Bayesian Logit Treed (BLTREED) and Classification and Regression Trees (CART) were implemented to discriminate βTT from IDA based on the hematological parameters. Results. This study proposes an automatic detection model of beta-thalassemia carriers based on a Bayesian tree-based method. The BLTREED model and CART showed that mean corpuscular volume (MCV) was the main predictor in diagnostic discrimination. According to the test dataset, CART indicated higher sensitivity and negative predictive value than BLTREED for differential diagnosis of βTT from IDA. However, the CART algorithm had a high false-positive rate. Overall, the BLTREED model showed better performance concerning the area under the curve (AUC). Conclusions. The BLTREED model showed excellent diagnostic accuracy for differentiating βTT from IDA. In addition, understanding tree-based methods are easy and do not need statistical experience. Thus, it can help physicians in making the right clinical decision. So, the proposed model could support medical decisions in the differential diagnosis of βTT from IDA to avoid much more expensive, time-consuming laboratory tests, especially in countries with limited recourses or poor health services.

scholarly journals Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices

2017 ◽  
Vol 33 (3) ◽  
Author(s):  
Tahir Ahmed Jameel ◽  
Mukhtar Baig ◽  
Ijaz Ahmed ◽  
Muhammad Barakat Hussain ◽  
Motlag bin Doghaim Alkhamaly
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Hematological Indices ◽  
Thalassemia Trait

scholarly journals Study of blood indices and high performance liquid chromatography (HPLC) in differentiation of β-thalassemia trait and iron deficiency anaemia

2017 ◽  
Vol 5 (11) ◽  
pp. 4728 ◽  
Author(s):  
Pravin M. Meshram ◽  
Hemant R. Kokandakar ◽  
Rajan S. Bindu
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Deficiency Anaemia ◽  
Beta Thalassaemia ◽  
Thalassaemia Trait ◽  
Patient Groups ◽  
Thalassemia Trait

Background: Iron deficiency anemia (IDA) and beta thalassaemia trait (BTT) are two of the most common causes of microcytic anemia.It is essential to differentiate between the two, so as to avoid unnecessary iron therapy which is contraindicated in beta thalassaemia .We retrospectively evaluated the reliability of various indices for differential diagnosis of microcytosis and 𝛽-TT in the same patient groups .Methods: A total of 200 patients were evaluated. We calculated 6 discrimination indices in all patients with anemia or suspected beta thalassemia. None of the subjects had  combined  IDA and 𝛽-TT. The patient groups were evaluated according to  the Mentzer, Shine and Lal, England and Fraser,Srivastava, Green and King, Ricerca.Results: According to percentage correctly diagnosed criteria, Ricerca  and Mentzer  index are considered as the two best discrimination indices in differentiation between β thalassemia trait  and iron deficiency anaemia .Youden’s index showed the following ranking with respect to the indices’ ability to distinguish between 𝛽-TT and IDA, Ricerca index >  Mentzer index > Green and King index >  Srivastava index >  Shine and Lal index > England and Fraser index.Conclusions: Ricerca  and Mentzer  index are considered as the two best discrimination indices in differentiation between β thalassemia trait  and iron deficiency anaemia.Keywords: Iron deficiency anemia (IDA) and beta thalassaemia trait (𝛽-TT) 

scholarly journals Blood Rheological Characterization of β-Thalassemia Trait and Iron Deficiency Anemia Using Front Microrheometry

2021 ◽  
Vol 12 ◽  
Author(s):  
Lourdes Méndez-Mora ◽  
Maria Cabello-Fusarés ◽  
Josep Ferré-Torres ◽  
Carla Riera-Llobet ◽  
Elena Krishnevskaya ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Microfluidic Channel ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Rheological Characterization ◽  
Gold Standard Method ◽  
Healthy Donors ◽  
Thalassemia Trait

The purpose of this work is to develop a hematocrit-independent method for the detection of beta-thalassemia trait (β-TT) and iron deficiency anemia (IDA), through the rheological characterization of whole blood samples from different donors. The results obtained herein are the basis for the development of a front microrheometry point-of-care device for the diagnosis and clinical follow-up of β-TT patients suffering hematological diseases and alterations in the morphology of the red blood cell (RBC). The viscosity is calculated as a function of the mean front velocity by detecting the sample fluid-air interface advancing through a microfluidic channel. Different viscosity curves are obtained for healthy donors, β-TT and IDA samples. A mathematical model is introduced to compare samples of distinct hematocrit, classifying the viscosity curve patterns with respect to the health condition of blood. The viscosity of the fluid at certain shear rate values varies depending on several RBC factors such as shape and size, hemoglobin (Hb) content, membrane rigidity and hematocrit concentration. Blood and plasma from healthy donors are used as reference. To validate their potential clinical value as a diagnostic tool, the viscosity results are compared to those obtained by the gold-standard method for RBC deformability evaluation, the Laser-Optical Rotational Red Cell Analyzer (LoRRCA).

scholarly journals “PREVALENCE OF BETA-THALASSEMIA TRAIT IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC”

2021 ◽  
pp. 45-47
Author(s):  
Uma Jain ◽  
Preeti Gupta ◽  
Shaily Sengar
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Gestational Age ◽  
High Performance ◽  
Hypochromic Anemia ◽  
Antenatal Clinic ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Thalassemia Trait

INTRODUCTION- Iron deficiency anemia and thalassemia syndromes,especially beta thalassemia trait (BTT),are the two most commonly ccuring microcytic hypochromic anemias highly prevalent in countries like India. Iron deficiency anemia is the first most common cause of anemia in pregnancy,beta thalassemia trait is the second most frequent cause of anemia of pregnancy. Patients with thalassemia trait shows an increased incidence of anemia during the second trimester of pregnancy. Beta Thalassemia Trait (BTT) patients are usually asymptomatic and ignorant of their carrier state unless diagnosed by testing. Screening for thalassemia can be done by measuring HbA2 levels MATERIAL AND METHOD- This is a retrospective study. The data were collected from a clinic and associated st pathology in Shivpuri and a private maternity hospital in Gwalior from 1 January 2019 to 30 June 2021.94 patients were included in the study.All pregnant women between the age of 18-45 years and at any gestational age with hemoglobin level <10g/dL and microcytic hypochromic anemia (report of CBC) were included in the study. High-Performance Liquid Chromatography (HPLC) and serum ferritin report were collected. RESULTS- In our study the most common age group in which the anemia was found between 19-35 years (80.85%).Most of the patients were primigravida (44.68%),between 26-37 wks of gestational age (82.97%),from a rural area (70.21%). Only 2 patients had a family history (2.12%) of beta-thalassemia and 6 patients had a history (6.38%) of blood transfusion. In our study moderate anemia was found in 55.31% of cases followed by mild anemia 25.53% and severe anemia 19.14%. In our study iron deficiency anemia was found in 87.23% only minor Beta-thalassemia was found to be 4.25%, of the patient,and the coexistence of iron deficiency anemia and beta-thalassemia in pregnant women is 8.51%. In our study total of 12 patients (4 cases of only minor beta-thalassemia and 8 cases of minor beta-thalassemia associated with IDA) The prevalence rate of beta-thalassemia in our study was 7.8%. CONCLUSION- the recommendation is to diagnose beta-thalassemia in pregnant patients is essential to give proper treatment.The screening of pregnant patients prevents unnecessary parental iron therapy and iron overload in case of anemia.further studies are needed in this field and less expensive and accurate methods should come in place.

scholarly journals Erythrocyte Catalase Activity in More Frequent Microcytic Hypochromic Anemia: Beta-Thalassemia Trait and Iron Deficiency Anemia

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sandra Stella Lazarte ◽  
María Eugenia Mónaco ◽  
Cecilia Laura Jimenez ◽  
Miryam Emilse Ledesma Achem ◽  
Magdalena María Terán ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Catalase Activity ◽  
Iron Status ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
Total Blood ◽  
Erythrocyte Catalase ◽  
Significant Difference ◽  
Thalassemia Trait

Most common microcytic hypochromic anemias are iron deficiency anemia (IDA) andβ-thalassemia trait (BTT), in which oxidative stress (OxS) has an essential role. Catalase causes detoxification of H2O2in cells, and it is an indispensable antioxidant enzyme. The study was designed to measure erythrocyte catalase activity (ECAT) in patients with IDA (10) or BTT (21), to relate it with thalassemia mutation type (β0orβ+) and to compare it with normal subjects (67). Ninety-eight individuals were analyzed since September 2013 to June 2014 in Tucumán, Argentina. Total blood count, hemoglobin electrophoresis at alkaline pH, HbA2, catalase, and iron status were performed.β-thalassemic mutations were determined by real-time PCR. Normal range for ECAT was 70,0–130,0 MU/L. ECAT was increased in 14% (3/21) of BTT subjects and decreased in 40% (4/10) of those with IDA. No significant difference (p=0,245) was shown between normal and BTT groups, while between IDA and normal groups the difference was proved to be significant (p=0,000). Inβ0andβ+groups, no significant difference (p=0,359) was observed. An altered ECAT was detected in IDA and BTT. These results will help to clarify how the catalase activity works in these anemia types.

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