Ehsani et al reported an index for determining if a patient with microcytic anemia has iron deficiency anemia (IDA) or beta-thalassemia minor. The authors are from Bahrami Children Hospital, the Iranian Blood Transfusion Organization and Tehran University of Medical Sciences in Iran.
Patient selection: MCHC < 30 g/dL, MCV < 80 fL if > 6 years or MCV < 70 if <= 6 years
Criteria for beta-thalassemia:
(1) hemoglobin A2 > 3.5%
(2) MCV < 80 fL and/or MCH < 27 pg/cell
Parameters:
(1) MCV in femtoliters
(2) RBCs in 10^12/L
index =
= (MCV) - (10 * (RBC))
Interpretation:
• An index > 15 is associated with iron deficiency anemia.
• An index < 15 is associated with beta-thalassemia minor.
Performance:
• The sensitivity for IDA was 90% with specificity 96%.
• The sensitivity for beta-thalassemia minor was 96% and specificity 90%.
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