A. Telmissani, S. Khalil, and T. R. George, “Mean density of hemoglobin per liter of blood: a new hematologic parameter with an inherent discriminant function,”, A. Mosca, R. Paleari, G. Ivaldi, R. Galanello, and P. C. Giordano, “The role of haemoglobin A(2) testing in the diagnosis of thalassaemias and related haemoglobinopathies,”, E. J. Harthoorn-Lasthuizen, J. Lindemans, and M. M. A. C. Langenhuijsen, “Influence of iron deficiency anaemia on haemoglobin A(2) levels: possible consequences for, A. Demir, N. Yaralı, T. Fısgın, F. Duru, and A. Kara, “Most reliable indices in differentiation between thalassemia trait and iron deficiency anemia,”, D. Aslan and Ç. Altay, “Incidence of high erythrocyte count in infants and young children with iron deficiency anemia: re-evaluation of an old parameter,”, M. Ferrara, L. Capozzi, R. Russo, F. Bertocco, and D. Ferrara, “Reliability of red blood cell indices and formulas to discriminate between, S. M. AlFadhli, A. M. Al-Awadhi, and D. AlKhaldi, “Validity assessment of nine discriminant functions used for the differentiation between Iron deficiency anemia and thalassemia minor,”, M. Ghafouri, L. Mostaan Sefat, and L. Sharifi, “Comparison of cell counter indices in differention of beta thalassemia trait and iron deficiency anemia,”, F. Rahim and B. Keikhaei, “Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait,”, G. Ntaios, A. Chatzinikolaou, Z. Saouli et al., “Discrimination indices as screening tests for, C. Rosatelli, G. B. Leoni, T. Tuveri et al., “Heterozygous, I. El-Agouza, A. Abu Shahla, and M. Sirdah, “The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: possible consequences for clinical diagnosis,”, P. R. Dallman, “Blood and blood-forming tissue,” in. This process helps to select appropriate individuals for a more detailed examination; however, no study has found 100% specificity or sensitivity for any of these RBC indices. The Shine and Lal and the Ricerca et al. Hb values in the β-TT group were 10.39 ± 0.69, and those in the IDA group were 10.23 ± 0.95 (). Signed informed consent was obtained from the parents of study subjects. We retrospectively evaluated the reliability of various indices for differential diagnosis of microcytosis and β-TT in the same patient groups. [2]. Anemia resulting from lack of sufficient iron to synthesize hemoglobin is the most common hematological disease in infants and children. Red blood cell (RBC) count and red blood cell distribution width (RDW) were assessed on a Siemens Advia 2120 Hematology Analyzer. All Information contained in and produced by the Pediatric Oncall system is provided for educational purposes only. The diagnosis of β-TT involves measuring the HbA2 concentration of lysed RBCs via HPLC. and the Shine and Lal indices demonstrated the highest sensitivity (100%) but had low specificities for correctly identifying IDA (14.7%) and β-TT (10.2%). The Mentzer index, described in 1973 by Mentzer, is said to be helpful in differentiating iron deficiency anemia from beta thalassemia. We encourage you to research and examine these records to determine their accuracy. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer. Misdiagnosis of β-TT has consequences for potential homozygous offspring. According to Youden’s index, the Shine and Lal index and RBC count showed the greatest diagnostic value in patients < 10 years (89% and 82%, resp.). This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. No accuracy specified. The RBC count is one of the most accurate indices available. ), and that the Green and King index had the highest efficiency (80.2%) in 458 children with mild microcytic anemia aged 1.8–7.5 years [17]. Background and aims Iron deficiency anaemia (IDA) and thalassemia are the most common microcytic anaemia in children. Hematological and biochemical date of study groups. The hemoglobin pattern of β‐thalassemia heterozygotes is characterized by 92%‐95% HbA, >3.8% HbA 2, and a variable amount of HbF (0.5% to 4%). Our data (Table 1) showed significant differences between the hematological and biochemical parameters of β-TT and IDA children except for Hb and RDW, but these differences were not reflected in the indices’ reliability in differential diagnosis of β-TT and IDA. The index is calculated from the results of a complete blood count. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden’s index were calculated for each measure as follows: Data were analyzed with computerized statistical package for social sciences (SPSS) version 15.0. The values of each index required to distinguish between β-TT and IDA and the number and proportion of correctly identified patients (true positives) calculated using these indices are shown in Table 3. index (84.8%). Introduction: None written. The prevalence of disease being 13%, the sensitivity, specificity and accuracy of our Mentzer’s Index and RDW index were appreciatively high in comparison to other studies regarding the two. The England and Fraser and the Mentzer indices demonstrated the highest specificities at 85.3% and 82.3%, respectively. Born in Liberty Mills, Wabash County, Indiana, USA on 12 Jan 1888 to Clayton Grube and Sarah June Mentzer-Grubs. However, studies in pediatric age groups are scarce, and their results are conflicting. Hb: hemoglobin; MCV: mean corpuscular volume; SD: standard deviation. The index is calculated from the results of a complete blood count.If the quotient of the mean corpuscular volume (MCV, in fL) divided by the red blood cell count (RBC, in Millions per microLiter) is less than 13, thalassemia is said to be more likely. [citation needed]Blood is drawn into a test tube containing liquid sodium citrate, which acts as an anticoagulant by binding the calcium in a sample. As indicated in Table 4, none of the indices studied demonstrated 100% precision in recognizing β-TT. values < 0.05 were considered significant. A definitive differential diagnosis between β-TT and IDA is based on the result of HbA2 electrophoresis, serum iron levels, and a ferritin calculation [3]. reported that the Green and King index was the most reliable index, as it had the highest sensitivity (75.06%), efficiency (80.12%), and Youden’s index (70.86%) for detecting β-TT [21]. In the 290 children with microcytic anemia, 186 children (64.1%) had a high RBC count (RBC count > 5.0 × 106/μL) at the time of diagnosis. According to our data, the Mentzer index had the highest Youden’s index for correctly distinguishing β-TT and IDA at 81%. D. A. Rathod, A. Kaur, V. Patel et al., “Usefulness of cell counter-based parameters and formulas in detection of, E. Urrechaga, L. Borque, and J. F. Escanero, “The role of automated measurement of RBC subpopulations in differential diagnosis of microcytic anemia and, C. Thomas and L. Thomas, “Biochemical markers and hematologic indices in the diagnosis of functional iron deficiency,”, W. C. Mentzer Jr., “Differentiation of iron deficiency from thalassaemia trait,”, I. The hematological and biochemical data of the groups are evaluated before iron replacement regimen. The differential values for each discrimination index were applied as defined in the original published reports: red blood distribution width index (RDWI), Mentzer index [4], the Shine and Lal index [5], the England and Fraser index [6], the Srivastava index [7], the Green and King index [8], the Ricerca et al. The β-TT group consisted of children with Hb levels of 9–11.46 g/dL, mean corpuscular volume (MCV) < 80 fL at age > 6 years or MCV < 70 fL at age < 6 years, serum iron level > 30 μg/dL, transferrin saturation > 16%, serum ferritin level > 12 ng/dL, and HbA2 > 3.5%. In 2009, Ehsani et al. compared nine discriminant functions in patients with microcytic anemia and measured validity using Youden’s index. The difference between the results of all of these indices and the gold standard (HbA2) was significant (). All trademarks used are the properties of their respective owners. Thalassemia and related hemoglobinopathies affect the quantity and quality of haemoglobin. Recently, Niazi et al. β‐thalassemia minor is identified by determining MCV, MCHC, and HBA 2. Red cell values at various ages of study groups and mean and lower limit of normal (−2 SD). Some have reported a lower sensitivity of 67% in Mentzer’s index while other studies have been higher with … None of the subjects had a combined case of IDA and β-TT. Patients with β-TT and concomitant iron deficiency may show normal HbA2 levels. 19, in 2009, compared a new index (MCV-10xRBC) with four other indexes (England-Fraser, Mentzer, Srivastava, and RBC) and demonstrated that the new index was able to identify 263 individuals (92.96%), inferior only to the Mentzer index, that correctly diagnosed 269 individuals (94.71%). A high erythrocyte count (RBC > 5.0 × 106/μL) is a common feature of IDA and β-TT. The Mentzer index showed good sensitivity, specificity, and Youden’s index values of 98.7%, 82.3%, and 81%, respectively. Keywords: anemia, mentzer index, RDW index, thalesemia. Sensitivity, specificity, PPV, NPV, and Youden’s index values for each index needed to distinguish between β-TT and IDA are shown in Table 4. Iron deficiency modulates HbA2 synthesis, resulting in reduced HbA2 levels in patients with IDA [13, 14]. The two most frequent types of microcytic anemia are beta thalassemia trait (β-TT) and iron deficiency anemia (IDA). According to our results, the percentage of correctly diagnosed patients was the highest with the Mentzer index (91%) followed by the Ehsani et al. MDHL index: mean density of Hb/liter of blood; MCHD index: mean cell Hb density. Diagnostic test analysis revealed a sensitivity of93%, specificity 84 %, and accuracy 90%. Those are shown in Table 1. Study: no study specified. Mentzer index and RDW is a test that is widely used by clinicians to differentiating early screening of Thalassemia with iron deficiency anemia. and RBC count (94.8%, 70.5%, and 65.3%). Background. Green and King Index: No accuracy specified. The content on this site is provided without warantee, expressed or implied, and without guarantee of accuracy. Most of these articles include adults but very few data are available on children. The site does not guarantee the accuracy or authenticity of the information. However, the frequency of high RBC count was 29.4% in children with IDA. The aim of the study was to analyze the reliability of these indices in distinguishing between the most common causes of microcyti… HbA2 was detected by high-performance liquid chromatography (Shimadzu LC-MS). indices demonstrated the highest NPV at 100%, and MCHD had the lowest NPV at 52.7%. Youden’s index considers both sensitivity and specificity and provides an appropriate measure of validity for a particular question or technique. demonstrated that RDWI had the highest sensitivity (78.9%), that the England and Fraser index had the highest specificity and highest Youden’s index (99.1 and 64.2%, resp. [Merge finding] Tags: None. HbA2 screening was performed after completion of the 16-week iron replacement regimen. Mentzer index, England and Fraser index, RDW index and Ehsani index each, showed high specificity (99.66%). Methods. A total of 154 children were confirmed to have β-TT. In this study, we compared the ability of different 12 indices to distinguish β-TT from IDA by calculating their sensitivity, specificity, and Youden’s index values. No test or parameter though, had a 100 % sensitivity or specificity. Distinguishing β-TT from IDA has important clinical implications because each disease has an entirely different cause, prognosis, and treatment. RBC count has been considered a valuable index [15], but we showed that RBC count had only 70.5% specificity and 65.3% Youden’s index. High diagnostic accuracy in distinguishing Thalassemia with iron deficiency anemia was RDW index (88.14%), and followed by Mentzer index (86.85%). The Mentzer index was the most reliable index, as it had the highest sensitivity (98.7%), specificity (82.3%), and Youden’s index (81%) for detecting β-TT; this was followed by the Ehsani index (94.8%, 73.5%, and 68.3%, resp.) Methods: This study was a prospective study done on 30 patients each of thalassemia trait … By this study's cut-off, the G&K and RDWI showed the highest accuracy, sensitivity, and specificity. We observed that the RBC count increased at the initiation of iron therapy in patients with IDA and decreased by the end of therapy. β-TT is the most common type of hemoglobinopathy transmitted by heredity. In their study, the Mentzer and Ehsani et al. CONCLUSION: MCV≤59.9 fL and Mentzer Index≤12.45 were the best discriminating indices obtained with high sensitivity, NPV, YI and ARUC. Records: 10. This information should not be used for the diagnosis or treatment of any health problem or disease. β-TT and IDA are among the most common types of microcytic anemia encountered by pediatricians. Additionally, Table 4 shows that the highest and lowest Youden’s index values belonged to the Mentzer index (81%) and MCHD (5.8%). The Mentzer family name was found in the USA, the UK, and Scotland between 1840 and 1920. Initial evaluation should include a complete blood count, including Hb and mean corpuscular volume, as well as a reticulocyte count, ferritin level, total iron-binding capacity, and transferrin saturation, permitting the calculation of a reticulocyte index and Mentzer index. The percentage of correctly diagnosed cases was the highest for Red Cell Distribution Width Index (RDWI) (84.19%) followed by Mentzer Index (86.85%). 2014, Article ID 576738, 7 pages, 2014. https://doi.org/10.1155/2014/576738, 1Department of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, Turkey, 2Department of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, 34010 Istanbul, Turkey, 3Department of Biochemistry, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey, 4Department of Pediatrics, Istanbul Training and Research Hospital, Istanbul, Turkey. Therefore, according to our results, these indices cannot be used as screening tools for β-TT, as using them could result in a significant number of false-negative results. They showed that the England and Fraser index had the highest Youden’s index value (98.2%) for correctly differentiating β-TT and IDA, whereas the Shine and Lal index was ineffective for differentiating microcytic anemia [18]. Study: no study specified. (2010)[7] analyzed 312 patients (213 BTT and 89 non-BTT) from Pakistan by calculating seven discrimination indices and found that none of them showed 100% sensitivity and specificity. Mentzer index: No accuracy specified. Keywords: Mentzer Index, diagnostic value, thalassemia 1. They found that the Mentzer index had 85% sensitivity, 93% specificity, and 79% Youden’s index [20]. The most Mentzer families were found in the USA in 1880. Our data showed that the S&L index had the highest Youden's index, with a value of 89%, in correctly differentiating between IDA and ß-thalassemia minor among patients aged younger than 10 years, while RDW and RBC count indices showed the highest Youden's index, with values of 93% and 90%, respectively, in the patients older than 10 years.In another research work, Ntaios et al. Individuals with the beta thalassemia trait (β-TT) are usually asymptomatic and may be unaware of their carrier status unless diagnosed by testing. Results: The highest accuracy (True positive + True negative/ All cases) & Youden's Index (Sensitivity+Specificity-100) were for Red Cell Distribution Width (RDWI) and Hameed index closely followed by Keikhaei index while the least performance was … %, .%, and %, respec-tively. Kerman 1 index Their results overlapped those of our study. It has been estimated that 30% of the global population suffers from iron deficiency anemia (IDA), and most of those affected live in the developing countries. Use of any information is solely at the user's own risk. indices were able to correctly diagnose 94.7% and 92.9% of cases, respectively, and both are easy to calculate [11]. index), have good discrimination ability in diagnosing β-TT. Mentzer index: Sensitivity and Specificity. The samples were obtained during the course of routine analysis and collected in EDTA anticoagulant tubes. High performance liquid chromatography (HPLC) is considered the gold standard for diagnosis of hemoglobinopathies. Sensitivity of Shine and Lal index was highest (98.4%) followed by Kerman 1 index (66.7%). Children with Hb levels < 8.7 g/dL were excluded because these cases of severe anemia are not confused with β-TT in daily practice. The authors declare that there is no conflict of interests regarding the publication of this paper. index [9], and the Sirdah et al. Due to the migration and intermarriage of different ethnic populations, β-TT is found in people with no obvious ethnic connection to the disorder. Electronic cell counters have been used to determine red cell indices as a first indicator of β-TT. Mentzer index, England and Fraser, Shine and Lal, Srivastava and Sirdah formulae were investigated. Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia, Department of Pediatrics, School of Medicine, Bezmialem Vakif University, 34093 Istanbul, Turkey, Department of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, 34010 Istanbul, Turkey, Department of Biochemistry, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey, Department of Pediatrics, Istanbul Training and Research Hospital, Istanbul, Turkey. The RBC count provided the best sensitivity (94.8%) but had low specificity (70.5%), and Youden’s index was 65.3%. [19]. None of them had received a transfusion or had an acute bleeding episode in the previous month. The patient groups were evaluated according to red blood cell (RBC) count; red blood distribution width index; the Mentzer, Shine and Lal, England and Fraser, Srivastava and Bevington, Green and King, Ricerca, Sirdah, and Ehsani indices; mean density of hemoglobin/liter of blood; and mean cell density of hemoglobin. A number of haematological indices are useful, but some of them assume difficult calculation. In this study, King-Green formula was reported to have the highest sensitivity and specificity, which as a result, was the most reliable formula followed by Mentzer formula. Associated Diagnoses: Thalassemia. SI and total iron binding capacity (TIBC) were determined calorimetrically (Siemens Advia 2400 Chemistry Analyzer), and ferritin was measured by immunoassay using a Siemens Advia XP Analyzer. Copyright © 2001 - 2021 Pediatric Oncall All Rights Reserved. The Mentzer index, described in 1973 by William C. Mentzer, is the MCV divided by the RBC count. We calculated 12 discrimination indices in all patients with hemoglobin (Hb) values of 8.7–11.4 g/dL. When the Mentzer index was calculated, 264 children with microcytic anemia (91%) were correctly diagnosed. Sometimes, expensive or invasive investigations are necessary for their distinction. This was about 50% of all the recorded Mentzer's in the USA. The England and Fraser and the Shine and Lal indices had the lowest Youden’s index values of 51.4% and 10.2%, respectively. The third highest one was RBC count (83.4%). This calculator calculates the mentzer index using mcv (mean corpuscular volume), red blood cell values. When the Mentzer index was calculated, 91% of children with microcytic anemia were correctly diagnosed. A similar result for the Green and King index (Youden’s index, 80.9%) was found by Urrechaga et al. Shine and S. Lal, “A strategy to detect, J. M. England and P. M. Fraser, “Differentiation of iron deficiency from thalassaemia trait by routine blood-count,”, P. C. Srivastava, “Differentiation of thalassemia minor from iron deficiency,”, R. Green and R. King, “A new red cell discriminant incorporating volume dispersion for differentiating iron deficiency anemia from thalassemia minor,”, B. M. Ricerca, S. Storti, G. d'Onofrio et al., “Differentiation of iron deficiency from thalassaemia trait: a new approach,”, M. Sirdah, I. Tarazi, E. Al Najjar, and R. Al Haddad, “Evaluation of the diagnostic reliability of different RBC indices and formulas in the differentiation of the, M. A. Ehsani, E. Shahgholi, M. S. Rahiminejad, F. Seighali, and A. Rashidi, “A new index for discrimination between iron deficiency anemia and beta-thalassemia minor: results in 284 patients,”, O. In conclusion, the cell-count-based indices, particularly the Mentzer index, are easily available and reliable methods for detecting β-TT. None of the subjects had a combined case of IDA and β-TT. index > Shine and Lal index > MCHD. Study: no study specified. The England and Fraser index had the lowest sensitivity of 66.2%, and identification was wrong in about 28% of β-TT cases. The site does not guarantee the accuracy or authenticity of the information. Youden’s index showed the following ranking with respect to the indices’ ability to distinguish between β-TT and IDA: Mentzer index > Ehsani et al. It seems that RBC alone was not a reliable tool for distinguishing β-TT from IDA. In line with the findings of … showed that the best discrimination index according to Youden’s criteria was the Mentzer index (90.1%), followed by the Ehsani et al. It may be that interpopulation differences in the effectiveness of various RBC indices for discriminating β-TT from IDA could be attributed to differences in the mutation spectrum of the thalassemia disease in different populations [22]. If a CBC indicates microcytic anemia, the Mentzer index is said to be a method of distinguishing between them.In practice, the Mentzer index is not a reliable indicator and should not, by itself, be used to differentiate. Samples were obtained from 121 boys and 169 girls with no clinical symptoms of acute or chronic inflammation or infectious diseases. We retrospectively analyzed 290 children with microcytic anemia (mean age: 6.2 ± 4.2 years; range: 1.1–16 years). The Ehsani et al. Cryoprecipitate Dosing for Fibrinogen Replacement, Predicting risk of severe complications in a child with sickle cell disease (miller et al), Generalized Anxiety Disorder - DSM-5 Criteria, USG Measurements of the Normal Spleen Length, Toronto Childhood Cancer Staging criteria for Acute lymphoblastic leukaemia. Aysel Vehapoglu, Gamze Ozgurhan, Ayşegul Dogan Demir, Selcuk Uzuner, Mustafa Atilla Nursoy, Serdar Turkmen, Arzu Kacan, "Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia", Anemia, vol.

Do Mcdonald's Ranch Need To Be Refrigerated, Where Is Thumbkin Meaning, Come Out From Among Them, Girls Dem Sugar, Alpha Gaming Mouse Model 7275,