A PROSPECTIVE STUDY TO EVALUATE THE UTILITY OF VARIOUS INDICES IN DIFFERENTIATING BETWEEN THALASSEMIA AND IRON DEFICIENCY ANEMIA

Background: β-Thalassemia trait (β-TT) and iron deciency anemia (IDA) are two of the most common causes of microcytic hypochromic anemia with different clinical implications. Thus, in this study various red blood cell (RBC) indices were evaluated to check their utility for differentiating β-TT and IDA. Methodology: Study was carried out in the pathology department of a tertiary care hospital for two years. Patients of microcytic hypochromic anemia were selected as per MCV value (<80fL). β-TT was diagnosed by Hb electrophoresis with HbA2>4% as β-TT cases. CBC and RBC Indices were assessed. Sensitivity, Specicity, Positive and Negative Predictive Values and Youden's index of each Index were calculated for IDA and β-TT. Results: 272 cases were included. Mentzer index had highest correct diagnosis (89.11%) followed by RDWI Index (88.72%). Highest sensitivity and specicity (100%) for β-TT was shown by Shine & Lal Index and England & Fraser Index, respectively and for IDA by England & Fraser and Shine & Lal Index, respectively. Mentzer Index and RDWI had high Youden's Index (79.35 and 78.34 respectively). Conclusion: Mentzer & RDWI have good discrimination ability between β-TT and IDA. Future studies must be planned to revise the cut-off values of RBC indices for screening β-TT.