Clinical Significance of Hematological Indices for the Differential Diagnosis of Iron Deficiency Anemia and Thalassemia Trait

Abstract

Background: The two most prevalent causes of microcytosis and hypochromic but have different causes and treatments, are iron deficiency anemia (IDA) and thalassemia trait (TT). Conventional diagnostic methods such as hemoglobin electrophoresis and Serum Ferritin are Reliable but may be costly and time-consuming, particularly in low resources. Therefore, Hematological Indices are CBC-derived tools that can be used for differentiation of IDA and TT.

Objectives: The present study assesses the diagnostic validity of several hematological indices for the distinction between TT and IDA.

Methods: A cross-sectional study was conducted on 171 patients who presented with microcytic anemia. IDA patients were confirmed through Serum Ferritin, whereas TT patients were diagnosed through Hb Electrophoresis between May 2024 and August 2024 in Test Zone Laboratory, Lahore, Pakistan, by convenience sampling technique. CBC parameters were analyzed on Sysmex XN 1000i.

Results: Significant differences were observed between IDA and TT groups in hemoglobin, RBC, MCV, MCH, and MCHC. Among All Srivastava Index performed the best with the highest diagnostic accuracy. Mentzer Kerman I also showed good results.  In contrast, MDHL and Sirachainan showed poor availability.

Conclusion: Hematological indices stood out as the simple yet effective and cost-friendly method for the differential diagnosis of Iron deficiency Anemia and Thalassemia Trait. The Srivastava Index emerged as the reliable indices that can be effectively utilized during routine Clinical practice.