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Comparison of cell counter indices in differentiation of beta thalassemia minor from iron deficiency anemia

Background and objectivesDistinguishing two common hypochromic microcytic anemias (i.e. iron deficiency anemia and minor thalassemia) needs expensive laboratory tests not readily available everywhere. A number of indices derived from original cell counter parameters were tried to screen patients; these indices are compared in this study. Materials and MethodsFour indices of England, Mentzer, Shine and MDHL were calculated for 110 cases of known thalassemia minors and 61 iron deficients. The best cut-off point for each index was selected by receiver operator characteristic (ROC) analysis reaching the highest sensitivity to separate thalassemics from iron deficients. Sensitivity and specificity of indices were compared. ResultsMentzer’s index(sensitivity:90.9, specificity:80.3) had the best results. ConclusionsIt seems Mentzer’s index can be used widely to screen hypochromic microcytic anemic patients. Tests like hemoglobin electrophoresis, genetic studies, serum iron, TIBC and ferritin measurement should be reserved for selected patients in refferal centers. In this way we reduce public health costs significantly.