Impact of Iron deficiency on diagnosis of Beta Thalassemia Trait.

Abstract

Objectives: We aimed to evaluate the effect of low serum ferritin levels on HbA2 values in BTT patients. Study Design: Cross-sectional study. Setting: Pathology department of University Medical & Dental College Faisalabad. Period: August, 2018 to July, 2019. Materials & Methods: One hundred and thirty seven subjects were included in the study after written informed consent. Those with serum ferritin < 10µg/L were taken as iron deficient. Based on serum ferritin levels, we divided our study participants into two groups (Group A Vs Group B). As ferritin is considered an acute-phase protein, 25/137 participants with leukocytosis were excluded from statistical analysis. We measured serum Ferritin on Cobas 6000 e611 and we assessed the red cell parameters on Sysmex (seven part differential XN 1000). Hb variants were analysed through High performance liquid chromatography (HPLC) based technique of BioRad D10. Results: After excluding 25 subjects with high Total leukocyte count (TLC), we are left with 112 subjects. We observed 26 participants in group A with Iron deficiency and 38 in group B with no Iron deficiency. Mean±SD serum ferritin in iron deficient group was 7.25±1.95 as compared to non-iron deficient group (87.63±7.35). Mean HbA2 value in group A was 4.56±0.04 and in group B it was 5.80±1.06 with significant statistical difference of P=0.0188. We also observed significant difference in the mean values of other Red cell indices (MCV, HCT MCHC, MCH) except for RBC count and RDW. Conclusion: This study shows that ID may reduce HbA2 levels. Overall, it does not essentially preclude the identification of BTT. It is recommended that Iron deficiency should be considered before measuring HbA2 levels in BTT.