Articles Vol. 66 No. CĐ1-NCKH 24/01/2025

11. APPLICATION OF ERYTHROCYTE INDEX FORMULAS IN THE DIFFERENTIAL DIAGNOSIS OF IRON DEFICIENCY ANEMIA AND MILD β-THALASSEMIA

Thu An Hoang Thi1,2, Dung Nguyen Ngoc3,4
1 Hanoi University of Public Health
2 Trường Đại học Y tế công cộng
3 National Institute of Hematology and Blood Transfusion
4 Viện Huyết học - Truyền máu Trung ương
Corresponding author: ha.ann2110@gmail.com
DOI: 10.52163/yhc.v66iCD1.1973
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Abstract

Introduction: Anemia is a global health issue with a high prevalence, particularly in Vietnam. The two leading causes of anemia are iron deficiency anemia and minor β-Thalassemia.

Objective: To assess the predictive value of formulas based on red blood cell indices and %Micro, %Hypo indices in the differential diagnosis of iron deficiency anemia and β-Thalassemia.

Subjects and methods: This was a retrospective cross-sectional study conducted on patients aged ≥ 16 years who were diagnosed with iron deficiency anemia or mild β-Thalassemia for the first time at the National Institute of Hematology and Blood Transfusion.

Results: From January 1, 2023, to March 31, 2024, 226 patients meeting the inclusion criteria were selected, including 127 iron deficiency anemia patients and 99 mild β-Thalassemia patients. The median MCV in the β-Thalassemia group (63.00 fl ± 0.70) was lower than in the iron deficiency anemia group (69.68 fl ± 0.60), while the MCHC in the mild β-Thalassemia group was 312 g/L (299-324), higher than in the iron deficiency anemia group at 294 g/L (286-304). The %Micro and %Hypo indices also revealed significant differences between the two groups. The highest-rated formula was the England & Fraser formula (AUC = 93.91%), followed by Green & King (AUC = 88.82%), Menzter (AUC = 87.31%), RDWI (AUC = 83.01%), Ricerca (AUC = 74.47%), Srivastava (AUC = 67.78%), and Shine & Lal (AUC = 65.54%). Based on the %Micro and %Hypo indices, the M/H formula had the highest AUC (93.64%), followed by M-H-RDW (AUC = 92.81%) and M-H (92.67%).

Conclusions: The England & Fraser formula and the M/H formula had the best predictive value for guiding the differential diagnosis between iron deficiency anemia and β-Thalassemia, particularly in resource-limited healthcare settings.

Keywords
Iron deficiency anemia mild β-Thalassemia hypochromic microcytic red blood cells
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