Evaluation of Red Blood Cell Indices and Parameter Formulas in Differential Diagnosis of Thalassemia Trait and Iron Deficiency Anemia for Children in Shenzhen Area of Guangdong Province in China

Abstract

To evaluate the efficiency of red blood cell indices and fomulas for the differential diagnosis of the thalassemia trait (TT) and iron deficiency anemia (IDA) for children in Shenzhen area of Guangdong Province in China. A total of 849 child patients from Shenzhen were enrolled, including 536 cases of TT and 313 cases of IDA. The sensitivity (SEN), specificity (SPE), positive predictive values (PPV), negative predictive value (NPV), and Youden's indices (YI) were analyzed using five red blood cell indices ［including red blood cell count, average red blood cell volune(MCV), average amount of red blood cell hemoglobin(CMH), red blood hemoglobin cancentration(MCHC), red blood cell distribution width(RDW)］ and 10 red blood cell paramter formulas including Mentzer, Green and King, Srivastava, Ricerca, RDWI, Sirdah, Huber-Herklotz, Ehsani, Shine and Lal, and England and Fraser. Receiver operating characteristic (ROC) curve was drawn. Green and King was the most reliable index, as it had the highest YI (63.7%) and area under ROC curve (AUC) (0.875), the SEN and SPE was 82.5% and 81.2%. The YI, SEN, SPE, and AUC for RDWI were 62.8%, 79.1%, 83.7%, and 0.870, respectively. The formulas of Green and King and RDWI can be used for the differential diagnosis of TT and IDA, suitable for chidren in Shenzhen, China.