Diagnostic Potential of Haematological Indices (Mentzer Index and RDWI) to Distinguish Iron Deficiency Anemia and βTT
DOI:
https://doi.org/10.37018/JFJMU/7881Keywords:
Iron Deficiency Anemia, β-thalassemia trait, Red Cell Distribution Width Index, Mentzer Index, DiagnosisAbstract
ABSTRACT
Background: Iron Deficiency Anemia (IDA) and β-thalassemia trait (βTT) are the most frequently encountered entities presenting with microcytic hypochromic anemia. It is essential to distinguish between IDA and βTT to avoid incorrect diagnosis of βTT and unnecessary iron therapy. The high cost and inaccessibility of specific confirmatory tests has led to the utilization of different red blood cell (RBC) indices to differentiate them. The objective of this study was to assess the diagnostic accuracy of RDWI and Mentzer Index for screening and differentiation of IDA and βTT in terms of cost-effectiveness, availability to be used as a valid screening tool in resource constraint settings.
Patients and methods: This analytical study was conducted at Hematology, Department, Service Institute of Medical Sciences/Services Hospital,Lahore. Total 322 patients with microcytic hypochromic anemia were enrolled . IDA was diagnosed on the basis of low serum ferritin (<15ng/ml) and βTT by HPLC, showing HbA2 >3.5%. Mentzer index and RDWI were calculated from parameters obtained by automated CBC analyzer. MI <13 and RDWI <220 favors βTT. MI >13 and RDWI >220 favors IDA. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and positive likelihood ratio of Mentzer and RDWI were calculated for IDA and βTT.
Results: MI has a PPV of 88.6%, NPV of 64.6%, an accuracy of 79.9%, and a positive likelihood ratio of 3.47. RDWI has positive predictive value of 93.8%, a negative predictive value of 74.8%, an accuracy of 87.2%, and a positive likelihood ratio of 6.44 for IDA. Positive likelihood ratio of MI and RDWI for BTT is 4.11 and 6.96 respectively.
Conclusion: MI and RDWI are valid screening tools with high diagnostic accuracy for initial screening and differentiation of IDA and βTT.
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