Screening for Thalassemia Carriers in Populations with a High Rate of Iron Deficiency: Revisiting the Applicability of the Mentzer Index and the Effect of Iron Deficiency on Hb A₂ Levels

Abstract

Differentiating between β-thalassemia (β-thal) minor and iron deficiency has important implications in thalassemia carrier screening. Several complete blood count (CBC)-based equations have been proposed for differentiating these two conditions. The applicability of these equations in populations with high rates of iron deficiency and β-thal minor, where patients can have both conditions, is limited. In addition, there have been conflicting reports on the possible effect of iron deficiency on Hb A₂ level with possible consequences for thalassemia screening programs. Here, we demonstrate that in our population the Mentzer Index separates individuals with β-thal minor from those without β-thal minor, regardless of their iron status. Iron deficiency also does not reduce Hb A₂ levels in β-thal minor patients. Correction of iron deficiency is not required for diagnosis of β-thal minor using high performance liquid chromatography (HPLC).

• Ferritin
• Hb A₂
• iron deficiency
• Mentzer Index
• screening
• thalassemia

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.