Differential diagnosis of microcytosis hyperchromic anaemia in children, correlation between peripheral blood film, erythrocyte indices, bone marrow study, and serum iron studies
Dr. PV Jatin and Dr. Kanak Kanti Mandal
Background and Objective: To determine the relative frequency of different etiologies of microcytic hypochromic anaemia. To establish a correlation between these values and iron profile readings, assuming there is a high level of sensitivity. In order to determine the red cell index that best detects the underlying cause of anaemia in the absence of iron values, particularly the red cell index with the highest sensitivity, it is necessary to examine the red cell distribution width.
Methods: In the investigation, a sample of 60 children aged 6 months to 12 years, diagnosed with microcytic hypochromic anaemia based on peripheral smear reports and complete blood hemograms, were selected through a random sampling method to examine the correlation between red cell indices and serum iron profile, assuming that these indices possess both sensitivity and specificity for the purpose of differential diagnosis.
Results: Among the 60 cases, 41 (82% of the total) were diagnosed with iron deficiency anemia (IDA), 8 (16%) affected by anemia of chronic disease, and only 1 (2%) had thalassemia major. The correlative investigation demonstrated that red cell distribution width (RDW) is the most sensitive diagnostic tool for iron deficiency anemia in the differential diagnosis of microcytic hypochromic anemia. A statistically significant connection was observed between the Recommended Dietary Weight (RDW) and blood iron profile. The sensitivity of the red cell formulas Sirdah, RBC count, was shown to be 100% in diagnosing IDA, followed by RDWI and Mentzer's index.
Conclusion: In the context of ACD cases, a cost-effective strategy involves establishing a correlation between clinical characteristics and conducting a CRP level assessment to validate the presence of an underlying chronic condition. If the anemia remains uncorrected following the therapy of the underlying condition, it may be necessary to conduct a serum iron test. All instances of ACD in our investigation exhibited increased levels of CRP, in addition to the clinical manifestations of underlying illnesses. In 6 out of 8 cases of ACD, the RDW was within the usual range. In the case of thalassemia major, the need for lifelong transfusions necessitates expensive procedures such as Hb electrophoresis to confirm the diagnosis.
