The value of the red cell distribution width index versus other parameters in the differentiation between iron deficiency anemia and beta thalassemia trait among children in Mosul, Iraq

ABSTRACT

Background

Iron deficiency anemia (IDA) in children may be confounded with the beta-thalassemia trait (BTT). This study aimed to reevaluate the role of the red blood cell distribution width index (RDWI) in distinguishing BTT from IDA.

Research design and methods

This cross-sectional study was conducted from June 2018 to February 2019 in two pediatric teaching hospitals in Mosul, Iraq. Two sets of patients with hypochromic microcytic anemia in the age range 6 months-12 years were included. The receiver-operating characteristics curve was used to identify the test best distinguishing BTT from IDA.

Results

In the first patient set, 54 (51.92%) had IDA and 50 (48.07%) had BTT. The area under the curve (AUC) for the RDWI was larger than for other parameters at 0.963, suggesting a discriminant tool to detect cases of BTT (p-value < 0.0001) . In the second patient set, 25 (42.85%) IDA cases and 20 (57.14%) BTT cases were analyzed, and the RDWI still had the highest AUC when compared with other parameters (p-value < 0.0001). An RDWI cutoff value suggested to differentiate BTT from IDA was 200.18 and 200.35 respectively for both groups.

Conclusions

RDWI may be a useful screening parameter in differentiating BTT from IDA.

KEYWORDS:

• Area under the curve
• beta-thalassemia trait
• ferritin
• hypochromic microcytic anemia
• red blood cell width

Acknowledgments

Special thanks to Taylor & Francis Editing Services for Manuscript Preparation assistance.

Author contributions

AH. Al-Numan conceived and designed the paper. RA. Al-Obeidi did the analysis and interpretation of the data; Both authors did the drafting of the paper and the approval of the version to be published, and all authors agree to be accountable for all aspects of the work.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.