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. 2018 Mar 31:17:31-36.
eCollection 2017 Jul.

Mean reticolocyte hemoglobin content index plays a key role to identify children who are carriers of β-thalassemia

Paolo Vicinanza  1 , Mariella Vicinanza  2 , Vincenzo Cosimato  3   4 , Daniela Terracciano  3 , Sergio Cancellario  1 , Angelo Massari  1 , Paolo Danise  5 , Carmine Selleri  4   6 , Bianca Serio  4   6
Affiliations

Mean reticolocyte hemoglobin content index plays a key role to identify children who are carriers of β-thalassemia

Paolo Vicinanza et al. Transl Med UniSa. .

Abstract

Reticulocyte (r) and red blood cell (RBC) indices provide reliable parameters for screening and monitoring iron deficiency anemia (IDA) patients and β-thalassemia trait (BTT) carriers. The aim of this study is to identify a simple method for use to distinguish β-thalassemia trait carriers from IDA and to evaluate the correlation between BTT genetic mutation and MCV values and new discrimination index for the detection of β-thalassemia trait (DI-BTT). We analyzed CHr, MCHCr, MCVr, RBC, mean cellular hemoglobin concentration (MCHC) and mean cellular volume (MCV) indices among a pediatric population of IDA patients (n=90), β-thalassemia trait carriers (n=72) and normal controls (NC) (n=131). Furthermore, to distinguish IDA patients from β-thalassemia trait carriers we evaluated clinical utility of new DI for the detection BTTcarriers, using the following polynomial: (RBC × MCHC × 50/MCV)/CHr. We found that CHr, MCVr and DI-BTT mean values were significantly different between β-thalassemia trait carriers and IDA patients. CHr, MCVr and DI-BTT plotting curves showed exclusive distribution in β-thalassemia trait carriers. Moreover, DI-BTT was very accurate in differentiating β-thalassemia trait carriers from IDA patients. All BTT patients showed a heterozygous mutation of the β-globin gene including CD39, IVS1.110, IVS1.6 and IVS2.745, IVS2.1 and IVS1.1. The highest MCV values were displayed by those carrying the IVS1.6 mutation.

Conclusions: The simultaneous measurement and plotting of CHr and MCVr indices, as well as the DI-BTT allow to distinguish β-thalassemia carriers from IDA patients.

Keywords: DI-BTT; iron deficiency; reticulocyte Indices; β-Thalassemia.

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Conflict of interest statement

Conflict of interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1. MCVr and CHr values of BTT patients show lower values compared to IDA patients
MCVr (Reticulocyte Mean Cellular Volume), CHr (Reticulocyte Mean contente Haemoglobin) in Iron deficient anemia (IDA) and trait β thalassemia carriers (BTT). MCVr (left axis) and CHr (right axis) had a different distribution in BTT patients compared to IDA patients
Fig. 2
Fig. 2
Correlation between discriminant index β Thalassemia Trait (DI-BTT) (y-axis) and six β thalassemia mutations (IVS1.6; IVS2.745; IVS1.110; IVS2.1; IVS1.1 and CD39) more frequent in the pediatric population of Salerno (Italy) (x-axis).
Fig. 3
Fig. 3
Correlations between mean corpuscolar volume (MCV) and β-thalassemia trait mutations
Fig. 4
Fig. 4
Discriminant index β-Thalassemia Trait (DI-BTT) (DI-BTT) of BTT has higher distribution curve compared to Iron Deficient Anemia (IDA).
See this image and copyright information in PMC

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