Vol. 8, Issue 4, Part A (2025)

Context: The microcytic erythrocytosis is largely confronted by the clinicians for its underlying etiology, either as iron deficiency anemia or beta thalassemia trait. The morphological differentiation between IDA and BTT is difficult on the peripheral smear examination and by cell counter studies. Therefore, a study was planned for MCHC anemia to be assessed by 6 commonly used indices worldwide for their discrimination capacities of IDA versus BTT.

Aims: The aim was to study six popular discriminant red blood cell indices to distinguish the iron deficiency anemia from beta thalassemia trait presenting as microcytic hypochromic anemia.

Settings and Design: Observational and analytical.

Methods and Material: Present study included 50 patients each in group A (IDA) and group B (BTT) based on the results of CBC, peripheral smear examination, S. Ferritin and HbA₂ analysis. Six indices were evaluated in the present study, Bessman index [RDW], Mentzer index, Srivastava index, Green and King index, Sirdah index and Ehsani index.

Statistical analysis used: The statistical tests for sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, accuracy and Youden’s index were used to compare the six indices amongst groups A and B.

Results: Group A included 12 males and 38 females (male to female ratio of 1: 3.2) and mean age of 25.02±11.24 years. Group B included 14 males and 36 females (male to female ratio of 1: 2.6) and mean age of 21.38±11.73 years. MI and EI showed highest values for Accuracy and YI when compared for screening of IDA and BTT patients, while BI [RDW] performed poorly for both the groups.

Conclusions: MI and EI can be reliably used for screening of MCHC anemia patients to categorise them to IDA or BTT.