Hematological indices in differentiation between iron deficiency anemia and beta-thalassemia trait

Background:Mild microcytic hypochromic anemias caused by iron deficiency (IDA) and beta-thalassemia trait (βTT) continue to be problematic and a significant threat to society, particularly in relatively poor developing countries.The goal of this study was to use accuracy approach to improve the diagnostic function of eight different prejudiced indices in Egyptian pediatric patients with microcytic anaemia. Materials and methods: Eight discrimination indices diagnostic performance presented in previous studies were introduced to analyze the differences between β-βTTand IDA among Egyptian paediatric patients by using evaluation metrics calculated from RBC indices by various mathematical formulae. CBC , iron study and hemoglobin electrophoresis were performed to all included participants. Results: A total of 300 Egyptian paediatric patients with βTT or IDA were enrolled. The Mentzer and Ehsani index exhibited the highest diagnostic accuracy (100%) followed by Sirdah (97.5%), Sirvistava (95%), MDHL (92.5%) Green & King, Recierca, (90%), and Matos(70%).Indices with AUCs greater than 0.8, such as Mentzer, Ehsani, and Sirdah, had very valuable predictive accuracy in distinguishing between β-TT and IDA. Conclusion: Although Hb electrophoresis is the gold standard for diagnosing βTT, in developing countries, the Mentzer index, followed by the Ehsani and Sirdah indices, could be used as a simple , cheap method to distinguish βTT from IDA in pediatric patients with mild microcytic hypochromic anaemia.