The Evaluation of Results of Twenty Common Equations for Differentiation of Beta Thalassemia Trait from Iron Deficiency Anemia: A Cross-Sectional Study
-
Hassan Ebrahimpour Sadagheyani
,
Rahim Sharafkhani
,
Shahriar Sakhaei
,
Hamid Jafaralilou
,
Parviz Shahmirzalou
Abstract
Background: Beta Thalassemia Trait (BTT) and Iron Deficiency Anemia (IDA) were two common clinical problems with clinical hypochromic and microcytic manifestations, and their differentiation from each other was very important and needs innovative formulas and laboratory tests. Since the consideration of anemia as a pair with BTT leads to beta-thalassemia major birth in 25% of cases, offering prospective parents detailed information about the likelihood of their offspring developing BTT is essential. The present study aimed to investigate the performance of common equations in differentiation of BTT from IDA.
Methods: In the present cross-sectional study, twenty common equations were selected in the differentiation of BTT from IDA. To evaluate the equations, the tests of 292 individuals (73 individuals with BTT and 219 individuals with IDA) were compared with the initial diagnosis of hypochromic and microcytic anemia using the formulas. Descriptive and value indices and Roc curve were utilized for all equations to analyze the results.
Results: Among twenty differential equations, Bordbar, Kerman I, II and Srivastava equations had the highest area under Roc curve (AUC) of 0.841, 0.838, 0.836, and 0.830 respectively, but Kandhro I. equation had the lowest AUC (0.378).
Conclusion: Given the importance of AUC and value indices of differential equations in clinical decision making, and results of evaluating common equations in differentiation of BTT from IDA. It is essential to improve the values of the equations by re-examining the parameters involved in them.
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13. Matos JrF, Dusse L, Borges KBG, et al (2016). A new index to discriminate between iron deficiency anemia and thalassemia trait. Rev Bras Hematol Hemoter, 38(3):214-9.
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15. Ullah Z, Khattak AA, Ali SA, et al (2016). Evaluation of five discriminating indexes to distinguish Beta-Thalassemia Trait from Iron Deficiency Anaemia. J Pak Med Assoc, 66(12):1627-1631.
16. Srivastava PC, Bevington JM (1973). Iron deficiency and-or thalassaemia trait. Lancet, 1(7807):832.
17. Shine I, Lal S (1977). A strategy to detect beta-thalassaemia minor. Lancet, 1(8013):692-4.
18. Sirdah M, Al Mghari K, Abuzaid AH, et al (2018). Should sex differences be considered when applying mathematical indices and formulas for discriminating β- thalassemia minor from iron deficiency? Pract Lab Med, 11:1-9.
19. Jayabose S, Giavanelli J, Levendoglu-Tugal O, et al (1992). Differentiating Iron Deficiency Anemia from Thalassemia Minor by Using an RDW-Based Index. J Pediatr Hematol Oncol, 21:314
20. Mentzer WC Jr (1973). Differentiation of iron deficiency from thalassaemia trait. Lancet, 1(7808):882.
21. Ricerca BM, Storti S, d'Onofrio G, et al (1987). Differentiation of iron deficiency from thalassaemia trait: a new approach. Haematologica, 72(5):409-13.
22. Ehsani M, Darvish A, Eslani A, et al (2005). A new formula for differentiation of iron deficiency anemia (IDA) and thalassemiatrait (TT). Turk J Hematol, 22(Suppl):268.
23. England JM, Bain BJ, Fraser PM (1973). Differentiation of iron deficiency from thalassaemia trait. Lancet, 1(7818):1514.
24. Green R, King R (1989). A new red cell discriminant incorporating volume dispersion for differentiating iron deficiency anemia from thalassemia minor. Blood Cells, 15(3):481-91; discussion 492-5.
25. Hafeez Kandhro A, Shoombuatong W, Prachayasittikul V, et al (2017). New bioinformatics-based discrimination formulas for differentiation of thalassemia traits from iron deficiency anemia. Lab Med, 48(3):230-237.
26. Sirdah M, Tarazi I, Al EN, et al (2008). Evaluation of the diagnostic reliability of different RBC indices and formulas in the differentiation of the beta-thalassaemia minor from iron deficiency in Palestinian population. Int J Lab Hematol, 30(4):324-330.
27. Sirachainan N, Iamsirirak P, Charoenkwan P, et al (2014). New mathematical formula for differentiating thalassemia trait and iron deficiency anemia in thalassemia prevalent area: a study in healthy school-age children. Southeast Asian J Trop Med Public Health, 45(1):174-82.
28. Bordbar E, Taghipour M, Zucconi BE (2015). Reliability of different RBC indices and formulas in discriminating between β-thalassemia minor and other microcytic hypochromic cases. Mediterr J Hematol Infect Dis, 7(1): e2015022.
29. Keikhaei B (2010). A new valid formula in differentiating iron deficiency anemia from ß-thalassemia trait. Pakistan Journal of Medical Sciences Online, 26(2):368-373.
30. Huber A, Ottiger C, Risch L, et al (2004). Thalassämie-syndrome: Klinik und diagnose syndromes thalassémiques: clinique et diagnostic. Forum Médical Suisse, 4:947-952.
31. Zaghloul A, Al-bukhari T, Bajuaifer N, et al (2016). Introduction of new formulas and evaluation of the previous red blood cell indices and formulas in the differentiation between beta thalassemia trait and iron deficiency anemia in the Makkah region. Hematology, 21(6):351-8.
2. Jaripour ME, Hayatigolkhatmi K, Iranmanesh V, et al (2018). Prevalence of B-Thalassemia Mutations among Northeastern Iranian Population and their Impacts on Hematological Indices and Application of Prenatal Diagnosis, a Seven-Years Study. Mediterr J Hematol Infect Dis, 10(1):e2018042.
3. Ahmadnezhad E, Sepehrvand N, fayyaz Jahani F, et al (2012). Evaluation and Cost Analysis of National Health Policy of Thalassaemia Screening in West-Azerbaijan Province of Iran. Int J Prev Med, 3(10):687-92.
4. Joosten E (2017). Iron deficiency anemia in older adults: A review. Geriatr Gerontol Int, 18(3):373-379.
5. Esmat B, Mohammad R, Behnam S, et al (2010). Prevalence of Iron Deficiency Anemia among Iranian Pregnant Women; a Systematic Review and Meta-analysis. J Reprod Infertil, 11(1):17-24.
6. Kabootarizadeh L, Jamshidnezhad A, Koohmareh Z (2019). Differential Diagnosis of Iron-Deficiency Anemia from β-Thalassemia Trait Using an Intelligent Model in Comparison with Discriminant Indexes. Acta Informatica Medica, 27(2):78-84.
7. Origa R(2000). Beta-Thalassemia. 2000 [up-dated 2000; cited 2000 Sep 28 [Updated 2018 Jan
25]]; Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK1426/
8. Hashemieh M, Timori Naghadeh H, Tabrizi Namini M, et al (2015). The Iran Thalassemia Prevention Program: Success or Failure? Iran J Ped Hematol Oncol, 5(3):161-6.
9. Samavat A, Modell B (2004). Iranian national thalassaemia screening programme. BMJ
, 329(7475):1134-1137.
10. Arora S, Rana D, Kolte S, Dawson L, et al (2018). Validation of new indices for differentiation between iron deficiency anemia and beta thalessemia trait, a study in pregnant females. International Journal of Scientific Reports, 4(2):26.
11. Jahangiri M, Rahim F, Saki Malehi A, et al (2019). Differential Diagnosis of Microcytic Anemia, Thalassemia or Iron Deficiency Anemia: A Diagnostic Test Accuracy Meta-Analysis. Mod Med Lab J, 3(1): 16-29.
12. Jameel T, Baig M, Ahmed I, et al (2017). Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices. Pak J Med Sci, 33(3):665-669.
13. Matos JrF, Dusse L, Borges KBG, et al (2016). A new index to discriminate between iron deficiency anemia and thalassemia trait. Rev Bras Hematol Hemoter, 38(3):214-9.
14. Sehgal K, Mansukhani P, Dadu T, et al (2015). Sehgal index: A new index and its comparison with other complete blood count-based indices for screening of beta thalassemia
trait in a tertiary care hospital. Indian J Pathol Microbiol, 58(3):310-5.
15. Ullah Z, Khattak AA, Ali SA, et al (2016). Evaluation of five discriminating indexes to distinguish Beta-Thalassemia Trait from Iron Deficiency Anaemia. J Pak Med Assoc, 66(12):1627-1631.
16. Srivastava PC, Bevington JM (1973). Iron deficiency and-or thalassaemia trait. Lancet, 1(7807):832.
17. Shine I, Lal S (1977). A strategy to detect beta-thalassaemia minor. Lancet, 1(8013):692-4.
18. Sirdah M, Al Mghari K, Abuzaid AH, et al (2018). Should sex differences be considered when applying mathematical indices and formulas for discriminating β- thalassemia minor from iron deficiency? Pract Lab Med, 11:1-9.
19. Jayabose S, Giavanelli J, Levendoglu-Tugal O, et al (1992). Differentiating Iron Deficiency Anemia from Thalassemia Minor by Using an RDW-Based Index. J Pediatr Hematol Oncol, 21:314
20. Mentzer WC Jr (1973). Differentiation of iron deficiency from thalassaemia trait. Lancet, 1(7808):882.
21. Ricerca BM, Storti S, d'Onofrio G, et al (1987). Differentiation of iron deficiency from thalassaemia trait: a new approach. Haematologica, 72(5):409-13.
22. Ehsani M, Darvish A, Eslani A, et al (2005). A new formula for differentiation of iron deficiency anemia (IDA) and thalassemiatrait (TT). Turk J Hematol, 22(Suppl):268.
23. England JM, Bain BJ, Fraser PM (1973). Differentiation of iron deficiency from thalassaemia trait. Lancet, 1(7818):1514.
24. Green R, King R (1989). A new red cell discriminant incorporating volume dispersion for differentiating iron deficiency anemia from thalassemia minor. Blood Cells, 15(3):481-91; discussion 492-5.
25. Hafeez Kandhro A, Shoombuatong W, Prachayasittikul V, et al (2017). New bioinformatics-based discrimination formulas for differentiation of thalassemia traits from iron deficiency anemia. Lab Med, 48(3):230-237.
26. Sirdah M, Tarazi I, Al EN, et al (2008). Evaluation of the diagnostic reliability of different RBC indices and formulas in the differentiation of the beta-thalassaemia minor from iron deficiency in Palestinian population. Int J Lab Hematol, 30(4):324-330.
27. Sirachainan N, Iamsirirak P, Charoenkwan P, et al (2014). New mathematical formula for differentiating thalassemia trait and iron deficiency anemia in thalassemia prevalent area: a study in healthy school-age children. Southeast Asian J Trop Med Public Health, 45(1):174-82.
28. Bordbar E, Taghipour M, Zucconi BE (2015). Reliability of different RBC indices and formulas in discriminating between β-thalassemia minor and other microcytic hypochromic cases. Mediterr J Hematol Infect Dis, 7(1): e2015022.
29. Keikhaei B (2010). A new valid formula in differentiating iron deficiency anemia from ß-thalassemia trait. Pakistan Journal of Medical Sciences Online, 26(2):368-373.
30. Huber A, Ottiger C, Risch L, et al (2004). Thalassämie-syndrome: Klinik und diagnose syndromes thalassémiques: clinique et diagnostic. Forum Médical Suisse, 4:947-952.
31. Zaghloul A, Al-bukhari T, Bajuaifer N, et al (2016). Introduction of new formulas and evaluation of the previous red blood cell indices and formulas in the differentiation between beta thalassemia trait and iron deficiency anemia in the Makkah region. Hematology, 21(6):351-8.
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| Issue | Vol 51 No 4 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i4.9255 | |
| Keywords | ||
| Red blood cell Thalassemia Anemia Mentzer index Differentiation equation | ||
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How to Cite
1.
Ebrahimpour Sadagheyani H, Sharafkhani R, Sakhaei S, Jafaralilou H, Shahmirzalou P. The Evaluation of Results of Twenty Common Equations for Differentiation of Beta Thalassemia Trait from Iron Deficiency Anemia: A Cross-Sectional Study. Iran J Public Health. 2022;51(4):929-938.
