Evaluation of microcytic hypochromic anemia by electrophoresis for hemoglobinopathies in young population

Abstract

Aim: To study hematological indices and peripheral smear examination in microcytic hypochromic anemia and to detect hemoglobinopathies by doing hemoglobin electrophoresis in microcytic hypochromic anemia. Study design: Cross sectional Study Place and duration of study: Department of Medicine Ghurki Trust Teaching Hospital, Between June 2010 and June 2014. Methods: Subjects for study obtained from the clinical cases suspected of anemia were 100 in total. All patients who presented with pallor and were detected to have microcytic hypochromic anemia on peripheral examination were included in the study. Anemic patients having cause other than microcytic hypochromic anemia and confirmed cases of Iron deficiency anemia were excluded. Investigations were done to confirm that Anemia is microcytic hypochromic anemia and to find out hemoglobinopathies as a cause MHA. Complete hemogram was performed and Hb electrophoresis was done after studying the iron profile and ruling out iron deficiency anemia by performing serum Iron level. Results: The study group included 53males and 47 females. Use of electrophoresis showed out of 100 cases, 21% of cases were thalassemia and 79% were iron deficiency anemia. Age distribution is not statistically associated with either Iron deficiency Anemia and Thalassemia with P=0.412. Gender is not statistically associated with either Iron deficiency Anemia and Thalassemia with P=0.358. 9 patients had history of consanguineous marriage which constituted 42.9%. The remaining 12 patients i.e. 57.1% did not give such history. Of the 21 cases of thalassemia, all (100%), presented with pallor, generalized weakness. Only 3 cases i.e.14.3% gave history of jaundice. None of the cases had any bleeding tendencies.13 cases i.e., 61.9% had iron overload 14 cases showed growth impairment, this constituted 66.7% of total. Conclusion: Most common cause of MHA was iron deficiency anemia and 2nd being thalassemia. Differential diagnosis based on complete hemogram and peripheral smear is possible but special tests like serum iron profile and hemoglobin electrophoresis are a must for confirmation of diagnosis.