Differentiation of Beta-Thalassemia Trait (β-TT) from Iron Deficiency Anaemia (IDA) by Haematological Indices

Abstract

Objective: to analyze and compare the accuracy of six haematological indices based on red blood cell (RBC) parameters in distinguishing between beta-thalassemia and iron deficiency anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Pathology Department, Combined Military Hospital, Quetta Pakistan, from Feb 2020 to Nov 2021. Methodology: Ninety study samples were included and referred to the Pathology department for the hypochromic microcytic blood picture workup. All the samples were subjected to Complete Blood Counts and haemoglobin electrophoresis. A test for serum ferritin level was also carried out on all individuals. Blood morphology, Mean Corpuscular Volume (MCV), Red Cell Distribution Width (RDW), and Red Blood Cell (RBC count) were noted from an automated haematology analyzer (SYSMEX X100). Six haematological discrimination indices for diagnostic performance were tested, namely: Mentzer index, Srivastava index (SI), Red Cell Distribution Width Index(RDWI), England and Fraser index(EF), Green and King (GK), and Shine and Lal index (SL), to analyze the differences between β-TT and IDA by using evaluation calculated from RBC indices by various mathematical formulae. Result: For delineating ofβ-TT from IDA, the Mentzer index is simple to use and accurate. In our study, the highest percentage of patients correctly diagnosed, 261(90%), was by the Mentzer index; the second-highest was by the RDWI 247(85%), and the third was Srivastava Index. Conclusion: In this study, the Mentzer index was a reliable and helpful index for differentiation between β-TT and IDA, as compared to another index.