Significance of New Index Matos and Carvalho Index in differentiation of iron deficiency anemia and beta thalassemia trait.

Abstract

Objective: To assess the value of the Matos and Carvalho index (MCI) in detecting beta thalassemia traits in patients with microcytic hypochromic anemia. Study Design: Retrospective study. Setting: Department of Hematology, CHK Central Laboratory Dr Ruth KM Pfau Civil Hospital Karachi, Pakistan. Period: 1^st July to 31^st December 2022. Methods: All newly diagnosed cases of iron deficiency and Beta Thalassemia trait were included. 297 patients with an age range of 1–60 years were evaluated. We calculated 4 discrimination indices in all patients with hemoglobin (Hb) values of <10 g/dL. The patient groups were evaluated according to red blood count; the Mentzer index (MI); the Srivastava index (SI) and Matos and Carvalho index (MCI). In this study complete blood counts for red cell indices were processed on a Hematology analyzer (XN-1000), HPLC was done on Arkray HA-8108T and serum ferritin was done on a chemistry analyzer (COBAS 501). Results: 297 patients were included in the present study with hypochromic, microcytic anemia for beta thalassemia trait (BTT) and iron deficiency anemia (IDA). HPLC detected 141 patients with BTT, while 156 were diagnosed with IDA. The average age of Patients with BTT was 14.5 years, whereas the average age of IDA patients was 20.6 years. The Mentzer index correctly identified patients at 64.6%, followed by MCI and SI at 63.2%, 62.2%, and 55.2%, respectively. Conclusion: The Matos & Carvalho Index offers an easy and accessible way to enhance thalassemia detection and iron deficiency anemia by the simple test of CBC at the frontline. In this study Srivastava index (SI) demonstrated the most robust reliability levels when distinguishing between beta thalassemia trait and Iron deficiency anemia. However, the absence of red cell indices and methods that possess 100% specificity, efficacy, and sensitivity hinders the differentiation of BTT from other hypochromic microcytic anemia.