Comparative Study of CBC based Indices in Microcytic Hypochromic Anemia to Detect Thalassemia Trait- An Experience at Tertiary Care Institute of Greater Noida Madhuvan1, Mishra Jyoti2,*, Deshmukh Ajoy3, Bindra Manjit Singh4, Nandeolikar Manoj Kumar5, Deshmukh Geeta4 1Junior Resident, Department of Pathology, SMS & R, Gr. Noida, UP 2Assistant Professor, Department of Pathology, SMS & R, Gr. Noida, UP 3Professor, Department of Medicine, SMS & R, Gr. Noida, UP 4Professor, Department of Pathology, SMS & R, Gr. Noida, UP 5Professor, Department of Biochemistry, SMS & R, Gr. Noida, UP *Corresponding author: Dr. Jyoti Mishra M.B.B.S. M.D. (Pathology) Assistant Professor, Department of Pathology, SMS&R, Greater Noida, Uttar Pradesh. Email: drm714@gmail.com, Tel. No. +91-7503783590
Online published on 17 July, 2019. Abstract Background Iron deficiency anemia (IDA) and thalassemia trait (βTT) are two most common causes of microcytic anaemia in our country. Though these conditions have similar red blood cell count parameters and blood picture, it is imperative to differentiate and correctly diagnose these two conditions so that unnecessary iron therapy can be avoided in thalassemia minor. Routine electronic red blood cell counts and indices driven from modern blood cell analyzers can provide fast, cheap and valuable clues to differentiate between IDA and thalassemia minor.. Aims & Objectives The aim of this study was to differentiate βTT from IDA through blood indices performed in routine complete blood count. Material & Method This was a cross-sectional comparative prospective study conducted from June 2016 to May 2018 in the Department of Pathology, SMS&R Greater Noida. One hundred ten cases of microcytic hypochromic anemia were included in this study. Complete blood count, red blood cell indices (England & Fraser, Shine & Lal, Green & King, Sehgal, RDW Index and Menzters index), peripheral blood smear, serum ferritin, HPLC was performed in all the cases. Results Of 110 cases IDA, sensitivity was maximum (95.6%) of England & Fraser index, specificity was maximum of Shine and Lal Index (94.7%). maximum positive predictive value was of Green & King Index (92.04%). In thalassemia, maximum sensitivity was of Shine & Lal (92.85%), specificity of England & Fraser (92%) and positive predictive value of RDW index (33.33%). Conclusion England & Fraser index (highest specificity, positive predictive value and negative predictive value) and Shine & Lal index (highest sensitivity and negative predictive value) most of the cases of with β-TT normal haemoglobin or mild anemia can be screened and later confirmed by HPLC. Top Keywords Red cell indices, thalassemia, β-TT, sensitivity, specificity. Top |