Value of the Matos and Carvalho index for thalassemia trait detection, experience of single hematological center in Iraq

Abstract

BACKGROUND: Thalassemia trait and other low red cell index (LRCI) diseases commonly have same presentation with microcytic hypochromic anemia. Most of beta thalassemia minor (TM) people are subclinical and without specific investigation may be undiagnosed or treated as iron-deficiency anemia. Thalassemia carriers may be undiagnosed, which in turn leads to severe forms of thalassemia syndromes with poor premarital counseling in high-prevalence areas. Many trials tried to find simple diagnostic tools to differentiate between thalassemia traits and other microcytic anemia depending on blood discriminative indices that can be found in limited resource places and routine clinics using blood cell count parameters. The aim was to assess the value of Matos and Carvalho index (MCI) in detecting TM from patients presented with microcytic anemia. PATIENTS AND METHODS: The study was carried out on 171 patients who were diagnosed as cases of hypochromic microcytic anemia in Kut Hemato-oncology Center. By Measuring hematological parameters using five automated red cell discriminative indices (red blood cell (RBC) count, RBC distribution width, Shine and Lal index, MCI index, and Mentzer index [MI]) with measuring hemoglobin (Hb) A2 levels using Hb variant B thalassemia short arm program. RESULTS: Of 171 patients screened for TM, 108 patients were diagnosed as TM by Hb electrophoresis. Patients with TM presented with the mean age of 25.3 years, while the mean of age in patients with other LRCI anemia was 6.2 years. RBC count was the best index of correctly identifi ed patients as 84%, followed by MI and MCI with 74% and 72%, respectively. Furthermore, the RBC count was the best indicator Youden's indices (58.2), with high sensitivity for BT (96.3%) followed by MI with Youden's index (38). Wide thalassemia mutation play important role in this issue. CONCLUSION: RBC count are simply accessible and dependable ways for identifying beta thalassemia trait, but there are no red cells indices and methods have 100% specificity, efficacy, and sensitivity for the differentiation beta TM from other hypochromic microcytic anemia which may be due to wide thalassemia mutations.