Role of Hematological Indices as a Screening Tool of Beta Thalassemia Trait in Eastern Uttar Pradesh: An Institutional S
- PDF / 226,352 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 111 Downloads / 162 Views
ORIGINAL ARTICLE
Role of Hematological Indices as a Screening Tool of Beta Thalassemia Trait in Eastern Uttar Pradesh: An Institutional Study Mudita Bhargava1 • Varsha Kumar1 Vatsala Misra1 • Poonam Gupta3
•
Himansha Pandey2 • Vasudha Singh1
•
Received: 6 February 2020 / Accepted: 18 April 2020 Ó Indian Society of Hematology and Blood Transfusion 2020
Abstract A large majority of microcytic hypochromic anemia have defects in cellular hemoglobin synthesis due to either iron deficiency or thalassemia trait; both differing in management and prognosis. HPLC and serum iron profile as confirmatory tests are unavailable at health care centers. Blanket therapy of iron supplements is therefore given in all such cases which may cause iron overload in thalassemia cases. Easy to use and cost effective screening methods are desirable. The present study was undertaken to evaluate the diagnostic accuracy of twelve indices to effectively screen cases of thalassemia trait and differentiate them from iron deficiency anemia. Routine samples from the hematology lab with Hb \ 13 gm/dl, MCV \ 80 fl and MCH \ 27 pg were screened. Taking HPLC and serum ferritin as gold standard, out of total 1353 cases, 98
cases of thalassemia trait (HbA2 [ 3.5 on HPLC) and 1102 cases of iron deficiency anemia (serum ferritin \ 12 g/ml) were evaluated using discrimination indices. Diagnostic accuracy for each index was calculated. While few indices showed a sensitivity of 100%, their specificity was low which meant more number of false positive cases. Based on Youden’s Index, which measures the diagnostic tests ability to balance sensitivity and specificity, the best three indices in the decreasing order of their efficacy in our study were Ricerca Index (RI), Green and King Index (GKI) and Mentzer Index (MI). MI is considered a reliable index by many clinicians since a long time, however RI and GKI were found to have a better diagnostic accuracy based on our study. Keywords Anemia Thalassemia HPLC Mentzer
& Varsha Kumar [email protected] Mudita Bhargava [email protected] Himansha Pandey [email protected] Vasudha Singh [email protected] Vatsala Misra [email protected] Poonam Gupta [email protected] 1
Department of Pathology, M.L.N. Medical College, George Town, Prayagraj 211002, India
2
Department of Pathology, VMMC and Safdarjung Hospital, New Delhi, India
3
Department of Medicine, M.L.N. Medical College, George Town, Prayagraj, India
Introduction Anemia is a widespread cause of morbidity globally. In a developing country, like India, Iron deficiency anemia (IDA) is a common health problem affecting both rural and the urban populations. Various health programs have been implemented for the prevention of IDA focusing on routine iron supplementation. Hemoglobinopathies especially Thalassemia constitutes a major cause of hematological morbidity, especially in childhood. The worldwide prevalence of Hemoglobinopathies carrier is estimated to be approximately 7% (ranging from 1 to 20%). The frequency of
Data Loading...
