Microcytic to hypochromic ratio as a discriminant index of thalassaemia trait in subjects with hypochromic anaemia
- Author:
Wee Shiang Yui
1
Author Information
1. Unit of Haematology, Department of Pathology, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur
- Collective Name:Siti Shahrum Muhamed Said; Raja Zahratul Azma Raja Sabudin; Hafiza Alauddin; Azlin Ithnin
- Publication Type:Journal Article
- Keywords:
thalassaemia trait;
hypochromic anaemia;
percentage of microcytic red blood cells;
percentage of hypochromic red blood cells;
microcytic to hypochromic ratio
- From:The Malaysian Journal of Pathology
2020;42(2):195-201
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Differentiating between thalassaemia and iron deficiency anaemia (IDA) in hypochromic
anaemia is a challenge to pathologists as it influences the choice of subsequent specialized confirmatory
tests. In this study, we aimed to evaluate the performance of microcytic to hypochromic ratio (MicroR/
Hypo-He, M/H ratio) as a discriminant index in hypochromic anaemia. Materials and Methods: A
retrospective study was carried out on 318 subjects with hypochromic anaemia, which comprised
162 IDA and 156 thalassaemia trait subjects with α-thalassemia, β-thalassemia and HbE trait.
Optimal cut-off value, sensitivity and specificity of M/H ratio for thalassaemia trait discrimination
was determined using Receiver Operating Characteristic (ROC) analysis. Results: Subjects with
thalassaemia trait showed higher MicroR compared to IDA ( p< 0.001) while subjects with IDA
demonstrated higher Hypo-He than thalassaemia trait (p < 0.001). M/H ratio was significantly higher
in thalassaemia trait compared to IDA, with medians of 3.77 (interquartile range: 2.57 – 6.52) and
1.73 (interquartile range: 1.27 – 2.38), respectively (p < 0.001). M/H ratio > 2.25 was the optimal
cut-off value for discriminating thalassaemia trait from IDA in hypochromic anaemia, with the
area under ROC curve (AUC) of 0.83, sensitivity of 80.8% and specificity of 71.6%. Conclusions:
M/H ratio is a useful discriminant index to distinguish thalassaemia trait from IDA in hypochromic
anaemia prior to diagnostic analysis for thalassaemia confirmation. High M/H ratio is suggestive
of thalassaemia trait than of IDA. However, more studies are required to establish the role of M/H
ratio as a screening tool for thalassaemia discrimination in hypochromic anaemia.
- Full text:5.2020my01061.pdf
