Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan;1(1):15-8.
doi: 10.4103/0974-2727.54802.

Hunt for the hidden trait

Vanamala Alwar  1 , Reeti Kavdia, Nandini Singh, Karuna Rameshkumar
Affiliations

Hunt for the hidden trait

Vanamala Alwar et al. J Lab Physicians. 2009 Jan.

Abstract

Objective: To assess the efficacy of a peripheral smear examination as a screening tool for β-thalassemia trait.

Materials and methods: 17 623 Leishman-stained peripheral smears were evaluated during the period from July 2006 to September 2007. The following parameters were studied: hemoglobin, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and red cell distribution width. All the cases that showed microcytosis, hypochromia, erythrocytosis and absence of anisopoikilocytosis were suspected of having the thalassemia trait (TT), and all these cases were further evaluated with Alkaline Hemoglobin Electrophoresis for confirmation.

Results: Of the 17 623 smears examined, 60 cases were considered suspicious of having TT. Alkaline hemoglobin electrophoresis carried out on all these cases revealed an elevated HbA(2) (Mean = 7.5%). Five cases evaluated were found to have other hemoglobinopathies (1 Sickle cell trait, 3 Hb-E, 1 thalassemia intermedia).

Conclusion: Careful screening of peripheral smear is an invaluable screening tool for thalassemia trait (PPV - 95%). There must be awareness among the peripheral centers about the importance of peripheral smear screening and the affected persons should be counseled.

Keywords: Iron deficiency anemia; Thalassemia trait; peripheral smear.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Peripheral smear showing Thalessemia trait (showing microcytic hypochromic RBCs) and presence of target cells (Leishman stain ×1000)
Figure 2
Figure 2
Peripheral smear showing iron deficiency anemia. Note the marked anisopoikilocytosis (Leishman stain ×1000)
See this image and copyright information in PMC

References

    1. Lukens JN. The thalassemias and related disorders: Quantitative disorders of hemoglobin synthesis. In: Lee GR, Bithell TC, et al., editors. Wintrobe's Clinical hematology. 9th ed. Philadelphia: Lea and Febiger; 1993. pp. 1102–45.
    1. Maheshwari M, Arora S, Kabra M, Menon PS. Carrier screening and prenatal diagnosis of β Thalassemia. Indian Pediatr. 1999;36:1119–25. - PubMed
    1. Weatherall DJ. The thalassemia. In: Beutler E, Lichtman MA, et al., editors. Willams Hematology. 6th ed. New York: McGraw Hill; 2001. pp. 547–80.
    1. Kotwal J, Saxena R, Choudhry VP, Dwivedi SN, Bhargava M. Erythrocyte indices for discriminating thalassaemic and non-thalassaemic microcytosis in Indians. Natl Med J India. 1999;12:266–7. - PubMed
    1. d’Onofrio G, Zini G, Ricerca BM, Mancini S, Mango G. Automated measurement of red blood cell microcytosis and hypochromia in iron deficiency and beta-thalassaemia trait. Arch Pathol Lab Med. 1992;116:84–9. - PubMed