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. 2015 Dec 25;5(2):101-7.
eCollection 2015.

Red cell parameters in infant and children from the Arabian Peninsula

Lolowa A Al Mekaini  1 , Srdjan Denic  2 , Omar N Al Jabri  3 , Hassib Narchi  1 , Abdul-Kader Souid  1 , Suleiman Al-Hammadi  1
Affiliations

Red cell parameters in infant and children from the Arabian Peninsula

Lolowa A Al Mekaini et al. Am J Blood Res. .

Abstract

α+-Thalassemia trait and iron deficiency anemia are frequent causes of microcytosis and a common diagnostic challenge in Arabian children. In this study, their prevalences and effects on the red cell parameters were evaluated in 28,457 children aged one day to 6 years. α+-Thalassemia trait was considered to be present when mean cell volume (MCV) was <94 fL at birth and iron deficiency anemia when red cell distribution width (RDW) was >14.5%. The prevalence of α+-thalassemia trait was 15.7% (502/3,191), which was similar to previously reported values for adults (9-14%). Iron deficiency anemia peaked at 7 months (53%) and then declined at a rate of 8% per year. The nadirs of red blood cell count (RBC) and hemoglobin concentration (Hb) occurred at two months of age (physiological anemia). Subsequently, Hb increased at a rate similar to that of MCV, demonstrating the two processes are coupled. The third percentile MCV in children older than 3 months was ≤64 fL, which was significantly lower than that in European children. The third percentile Hb, on the other hand, was similar to that in European children. Thus, α+-thalassemia trait and iron deficiency anemia are exceptionally frequent in Arabian children and their red cell indices are considerably different from European-based norms. Careful interpretation of red cell parameters is required for the evaluation of microcytic anemia in Arabian children.

Keywords: Thalassemia trait; decision-making; geo-ethnicity; nutritional iron deficiency.

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Figures

Figure 1
Figure 1
Age-dependent changes (per year) of red cell parameters.
Figure 2
Figure 2
Frequency of RDW >14.5% (phenotype-derived iron deficiency anemia) in 28,457 children.
Figure 3
Figure 3
MCV distribution in one-day-old neonates.
See this image and copyright information in PMC

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