Comparison of erythrocyte indices to differentiate between iron deficiency and alpha-thalassaemias in children with microcytosis and/or hypochromia

Erythrocyte indices used to differentiate between iron deficiency anaemia [IDA] and thalassaemias have been studied mainly in countries with a high prevalence of IDA or beta-thalassaemias. This study was carried out in the United Arab Emirates where alpha-thalassaemias are prevalent. We studied the predictive value and Youden index of several indices in 85 children aged 6 months to 12 years with microcytosis and/or hypochromia, with or without anaemia [determined by serum measurement of iron or therapeutic iron trial]. The best discriminatory indices for detecting IDA versus alpha-thalassaemias were a Green -King index > 65 [correctly identified 75.3% of children, Youden index 44.3] and red cell distribution width > 14% [correctly identified 57.8%, Youden index 38.1]

Evaluation of erythropoiesis in protein energy malnutrition

This study evaluated erythropoiesis in 50 infants hospitalized with protein energy malnutrition and in 50 control infants. The red cell count, mean corpuscular haemoglobin and reticulocyte index were significantly lower, while the white blood cell count, median corpuscular fragility and red cell distribution width were significantly higher on admission than in controls. Total serum protein, albumin, fasting blood glucose, and serum folate were significantly lower on admission than in controls. Serum ferritin was significantly higher and total iron-binding capacity was significantly lower on discharge compared to controls. The serum erythropoietin was significantly higher on admission and discharge than in controls. The anaemia of protein energy malnutrition is due to mixed deficiencies resulting in ineffective erythropoiesis despite an increased level of erythropoietin

Correlation between normal glucose-6-phosphate dehydrogenase level and haematological parameters

The study involved 143 individuals and aimed to correlate normal glucose-6-phosphate dehydrogenase [G6PD] level with haematological parameters. A statistically significant negative correlation was found between G6PD level and haemoglobin, packed cell volume, red blood cell count, mean corpuscular haemoglobin and mean corpuscular volume. A statistically significant positive correlation was found between G6PD level and white blood cell count and reticulocyte count, but no significant correlation was found between G6PD level and mean corpuscular haemoglobin concentration. The negative correlation between G6PD level and haemoglobin suggests that anaemic people have higher G6PD levels than normal individuals. The positive correlation between G6PD level and white blood cell count indicates that white blood cells may play an important role in contributing to G6PD level

Molecular studies on Yemeni sickle-cell-disease patients: Xmn I polymorphism

Our studies of the Saudi population have shown that in patients with mild presentation of sickle-cell disease [SCD] from Saudi Arabia's eastern region, the prevalence of polymorphic sites is high. However, the prevalence is very low in patients with severe SCD from the south-west of the country. We expanded these studies to a group of Yemeni patients with severe SCD, resident in Riyadh. We investigated a total of 60 chromosomes carrying the sickle-cell [Hb S] gene and 14 chromosomes carrying the Hb A gene. Amongst the Hb AA group, the prevalence was 42.9% and 57.1% for the presence [+] and absence [-] of Xmn I polymorphic sites. In the Hb SS individuals, the prevalence of Xmn I polymorphic sites was similar to the prevalence reported in the south-western region of Saudi Arabia

Pattern for alpha-thalassaemia in Yemeni sickle-cell-disease patients

A group of Yemeni patients with sickle-cell disease [SCD] and normal Hb AA individuals living in Riyadh were studied to determine the incidence of the alpha-gene molecular defect. Blood samples were obtained from 26 SCD patients and 19 controls [the Hb AA group]. In the SCD patients the frequency of single alpha-gene deletion [-alpha/alpha alpha] was 0.346, compared to 0.263 in the Hb AA group. The frequency of two gene deletion [-alpha/-alpha] was 0.231 [0.0 for the Hb AA group]. In one Hb AA case, a triple alpha-gene arrangement [alpha alpha alpha/alpha alpha] was found [frequency 0.053]. The results suggest that alpha-thalassaemia occurs frequently in Yemeni SCD patients. Further studies to determine the overall frequency of alpha-thalassaemia in the Republic of Yemen would be of value for patient management