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Discriminant value of % microcytic/% hypochromic ratio in the differential diagnosis of microcytic anemia
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Eloísa Urrechaga
Published/Copyright:
December 1, 2008
Abstract
Background: % Microcytic and % hypochromic red cells show an inverse trend in β thalassemia trait and in iron deficiency anemia (IDA). The aim of this study was to assess the discriminant value of % microcytic/% hypochromic ratio, as can be obtained from the Advia 2120 (Siemens) analyzer, in the differential diagnosis of microcytic anemia, compared to the conventional England and Fraser, Green and King, Mentzer, Ricerca, Shine and Lal and Srivastava indices.
Methods: Receiver operating characteristic (ROC) curves, sensitivity, specificity and Youden index of indices were calculated for a set of 148 IDA patients and 170 β thalassemia carriers.
Results: The Green and King index showed the best area under the curve (AUC, 0.962), with a Youden index of 80.9%; the % microcytic/% hypochromic ratio ranked second (AUC 0.943), with a Youden index of 76.3% and a sensitivity of 99.2%.
Conclusions: This index, with high sensitivity for β thalassemia screening, can be a useful tool in the differential diagnosis of microcytic anemia, so samples can be chosen for HbA2 analysis, to confirm the presumptive diagnosis of the disease. As specificity is 77.1%, we assume it will be 22.9% for false positives, but these samples will have HbA2 values within the reference range, for correct diagnosis.
Clin Chem Lab Med 2008;46:1752–8.
Keywords: β thalassemia screening; erythrocyte discriminant indices; iron deficiency anemia; microcytic anemia differential diagnosis; microcytosis; hypochromia
Received: 2008-6-6
Accepted: 2008-8-28
Published Online: 2008-12-01
Published in Print: 2008-12-01
©2008 by Walter de Gruyter Berlin New York
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Keywords for this article
β thalassemia screening;
erythrocyte discriminant indices;
iron deficiency anemia;
microcytic anemia differential diagnosis;
microcytosis;
hypochromia
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- Identification of two de novo mutations in Chinese patients with X-linked adrenoleukodystrophy
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