Discrimination index of microcytic anemia in young soldiers: a single institutional analysis.
PLoS One
; 10(2): e0114061, 2015.
Article
in En
| MEDLINE
| ID: mdl-25679510
ABSTRACT
BACKGROUND:
The common differential diagnosis of microcytic anemia in young Asian men includes iron deficiency anemia (IDA), α-thalassemia (αT) and ß-thalassemia (ßT). In this study, we aimed to distinguish between these diseases in a distinct population of young men using a specific index. PATIENTS ANDMETHODS:
We retrospectively reviewed the laboratory data of young men with microcytic anemia. The clinical, characteristic and laboratory data, including complete blood cell counts, serum ferritin and hemoglobin electrophoresis results, were collected; genomic DNA mutations were also evaluated. Based on these data, ten discrimination indices were used to differentiate thalassemia from IDA. The sensitivity, specificity, positive and negative predictive values, Youden's index and receiver operating characteristic (ROC) curves were also calculated.RESULTS:
A total of 877 patients (92 patients with IDA, 332 with αT and 453 with ßT) were enrolled; the Shine and Lal (S&L) formula was the best method with which to discriminate IDA from thalassemia (100% sensitivity, 91% specificity). The new cut-off values were evaluated, and the approaches used in our study cohort, particularly the Green & King (G&K) formula, significantly increased the accuracies of red cell distribution width-containing indices (cut-off value 58.66; 89.62% sensitivity and 96.2% specificity; AUC 0.9716). In addition, when applied properly, these indices could differentiate IDA patients from αT patients, especially Huber-Herklotz index (HH).CONCLUSIONS:
The sensitivity and specificity differed among ethnic and age groups. We concluded that when using the original cut-off value, the S&L formula was the best discriminating index for differentiating between IDA and thalassemia in young Asian men. However, when using the G&K formula, the newly obtained cut-off value must be applied to increase accuracy based on the results from our cohort.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anemia
/
Military Personnel
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
PLoS One
Journal subject:
CIENCIA
/
MEDICINA
Year:
2015
Document type:
Article
Affiliation country:
Taiwan