The role of erythrocyte indices in the differential diagnosis of microcytic anemia disorders

İlter Demirhan, Safiye Şeyma Taner, Mahmut Ay, Emrah Aksan, Ergül Belge Kurutaş

Abstract


The survival of the cells in the tissue depends on the delivery of sufficient oxygen. A small decrease in the erythocyte mass responsible for carrying blood to tissues causes hematological problems called anemia. Anemia cases are often considered as predictor of important diseases. İn this respect, anemic diseases should be taken seriously and their causes should be investigated and evaluated. Iron deficiency anemia (IDA) and beta thalassemia minör (BTM) are microcytic anemia types. Iron deficiency anemia (IDA) is the most common form of anemia in the population. DEA and BTM are forms of anemia and are differentiated from each other with the help of differential diagnoses. In our study, the role of erythrocyte indices obtained from hemogram parameters in the differential diagnosis of IDA and BTM was investigated. Our studies were carried out in Kahramanmaraş Necip Fazıl City Hospital Hematology Policlinic and Kahramanmaraş Provincial Public Health Directorate Thalassemia Laboratory between January-March 2016. A total of 52 patients who applied to the relevant centers on a voluntary basis were included in our study. Only patients with beta thalessemia minör and ıron deficiency anemia, including 25 patients with IDA, 5 patients with BTM and 22 patients with ıron deficiency beta thalessemia (DETM), were included in the study. İt has been calculated with the red blood cell indexes that are Mentzer İndex (MI), Green & King İndex (G&K), England & Fraser İndex (E&F), RDW İndex, Ricerca İndex (RI), Srivastava İndex (SI) ve Shine & Lal İndex (S&L), in the differential diagnosis of patients that have iron deficiency anemia (IDA) and BTM. The red blood cell indexes YI (Youden Index) values were found as S&L (%100)>RI (%84) >E&F (%72) > RDW (%64) > G&K (%64) > RDWI (%64) > SI (%56) > MI (%44) >RBC (%44) in the differential diognosis of (IDA) and BTM. YI (Youden Index) values of the red blood cell indexes were found as RDW (%100) > S&L (%96,29) RI (%72,8) > G&K (%54,37) >E&F (%51,25) > RDWI (%50,6) > SI (%50,07) > RBC (%49,18) > MI (%45,18) in the differantial diognosis patient group and ‘’ BTM with DETMER’’ diagnosed patient group. S&L, RI and E&F has the highest index value in the differential diognosis of BTM and IDA. it can be used as a differential diagnosis in patients whose erythrocyte index and iron deficiency or beta thalessemia are thought to be minor. Hb electrophoresis, HPLC analysis and mutation analysis are required for definitive diagnosis.


Keywords


Iron deficiency anemia; beta thalessemia minor; red cell indices

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References


Adamson, J.V. (2005). Iron defiency and other hypoproliferatif anemias. Harrison’s Principles of Internal Medicine, 593-600.

Akgüneş, E., Hasbal, C., Dedeoğlu, R., Yavaş, B., Yolar, L., Hatipoğlu, S. (2005). Çocuklarda demir eksikliği tarama testi olarak eritrosit indekslerinden RDW ve MCV’nin irdelenmesi. Bakırköy Tıp Dergisi, 3, 6-9

Arcasoy, A. (1994). Türkiye’de Thalassemia taşıyıcı sıklığı ve anormal hemoglobinler. Ankara Talasemi Derneği.

Beyan, C., Kaptan, K., Ifran, A. (2007). Predictive value ofdiscrimination indices in differential diagnosis of iron deficiency anemia and beta thalassemia trait. Eur J Haematol, 79, 524-526.

Cooley, J.R., Kitay, D.Z. (1984). Heterozygous beta-thalassemia in pregnancy. J Reprod Med, 29, 141-142.

Çavdar, A.O., Arcasoy, A. (1971). The incidence of ß-thalassemia and abnormal hemoglobins in Turkey. Acta Hematol, 45, 312-318.

Demir, A., Yarali, N., Fisgin, T., Duru, F., Kara, A. (2002). Most reliable indices in differentiation between thalassemia trait and iron deficiency anemia. Pediatr Int, 44, 612–616.

Gülez, P., Kayserili, E., Tosun, A., Eryılmaz, N. (1998). Demir eksikliği anemisinde eritrosit parametrelerinin karşılaştırılması. Klinik Bilimler&Doktor, 4, 875-877

Haznedar, R. (2003). Hipokrom mikrositer anemiler. Temel İç Hastalıkları. Ankara: Güneş Kitabevi.

Hoffbrand, A.V., Moss, P.A.H., Pettit, J.E. (2006). Eritropoiesis and general aspects of anemia. Essential Hematology. Oxford: Blackwell publishing, 12-28.

Kern, W.F. (2002). Introduction to Anemia. PDQ Hematology. Canada: Hamilton, 35-49.

Keskin, A., Polat, A., Türk, T., Sermez, Y. (2000). Erken demir eksikliğinin teşhisinde eritrosit dağılım genişliği (RDW)’nin değeri. Haseki Tıp Bülteni, 38, 119- 121.

Mentzer WC. (1973). Differentiation of iron deficiency from Thalassaemia trait. Lancet, 1(7808), 882

Ntaios G, Chatzinikolaou A, Saouli Z, Girtovitis F, Tsapanidou M, Kaiafa G., Kontoninas, Z., Nikolaidou, A., Savopoulos, C., Pidonia, I., Alexiou-Daniel, S. (2007). Discrimination indices as screening tests for β-thalassemic trait. Ann Hematol, 86, 487-491

Okan, V., Cigiloğlu, A., Çiftci, S., Yılmaz, M., Pehlivan, M. (2009). Red cell ındices and functions differentiating patients with the β thalassaemia trait from those with ıron deficiency anaemia. The Journal of International Medical Research, 37, 25–30.

Rahim, F., Keikhaei, B. (2009). Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait. Turk J Hematol, 26, 45-138.

Steensma, P.D., Rajiv, K.P. (2008). Hemotology Part 11. In: Ghosh AK, editor. Mayo Clinic Internal Medicine Review. Mayo Clinic Scıentıfıc Press, 409-411.

Turgeon, M.L. (2005). Hypochromic anemias and disorders of iron metabolism. Clinical Hematology: Theory and Procedures. Philadelphia: Lippincott Williams & Wilkins, 131-144.


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