Reticulocyte Hemoglobin Equivalent (Ret-He) Combined with Red Blood Cell Distribution Width Has a Differentially Diagnostic Value for Thalassemias

Autor:	Jun Shi, Yu Lian, Yizhou Zheng, Meili Ge, Min Wang, Yingqi Shao, Peng Jin, Jinbo Huang, Zhendong Huang, Jing Zhang, Neng Nie, Xingxin Li
Rok vydání:	2019
Předmět:	Erythrocyte Indices Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Reticulocytes Thalassemia Clinical Biochemistry Diagnosis Differential Hemoglobins 03 medical and health sciences 0302 clinical medicine Reticulocyte hemic and lymphatic diseases Internal medicine medicine Humans Congenital sideroblastic anemia Genetics (clinical) Retrospective Studies Anemia Iron-Deficiency business.industry Biochemistry (medical) Microcytic hypochromic anemia Genetic Diseases X-Linked Red blood cell distribution width Hematology medicine.disease Anemia Sideroblastic Endocrinology medicine.anatomical_structure Iron-deficiency anemia 030220 oncology & carcinogenesis Female Hemoglobin Differential diagnosis business 030215 immunology
Zdroj:	Hemoglobin. 43:229-235
ISSN:	1532-432X 0363-0269
DOI:	10.1080/03630269.2019.1655440
Popis:	As a type of congenital microcytic hypochromic anemia, thalassemia trait is often confused with other conditions, such as congenital sideroblastic anemia (CSA) and iron deficiency anemia, before a specific work-up is performed. However, these tests, including hemoglobin (Hb) electrophoresis, gene mutations and Prussian blue staining after bone marrow aspirate, are relatively expensive, time-consuming and invasive. To find labor-saving parameters to facilitate differential diagnosis, we retrospectively analyzed the routine blood indexes of 59 thalassemia trait cases [22 α-thalassemia (α-thal), 36 β-thalassemia (β-thal) and one α/β-thal], 21 CSA patients, and 238 iron deficiency anemia controls. Significantly higher reticulocyte Hb equivalent (Ret-He) and lower red blood cell (RBC) distribution width (RDW) were prominent in thalassemia trait. Furthermore, RDW-standard deviation (SD) was independent of the severity of anemia in thalassemia trait, similar to Ret-He in CSA. In the context of the same grades of anemia, Ret-He combined with RDW was powerful in differentiation of thalassemia from CSA and iron deficiency anemia. By receiver operation curve (ROC) analysis, Ret-He had a specificity of 67.06% and a sensitivity of 76.92% with a cutoff value of 20.9 pg for thalassemia trait in mild anemia and a specificity of 84.09% and a sensitivity of 68.42% with a cutoff value of 19.1 pg for thalassemia trait in moderate anemia. Regarding CSA, Ret-He had 92.94% specificity and 60.00% sensitivity in mild anemia, with a cutoff value of 18.1 pg. Overall, Ret-He and RDW are two convenient indexes able to differentiate thalassemia from the other two microcytic anemias, CSA and iron deficiency anemia.
Databáze:	OpenAIRE
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