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Evaluation of the new red cell parameters on Beckman Coulter DxH800 in distinguishing iron deficiency anaemia from thalassaemia trait
Author(s) -
Ng E. H. Y.,
Leung J. H. W.,
Lau Y. S.,
Ma E. S. K.
Publication year - 2015
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12262
Subject(s) - receiver operating characteristic , iron deficiency , medicine , red cell , gastroenterology , reticulocyte , red blood cell , area under the curve , hereditary spherocytosis , anemia , nuclear medicine , chemistry , biochemistry , messenger rna , gene
Summary Introduction The new red blood cell ( RBC ) parameters such as reticulocyte haemoglobin content and percentage of hypochromic red cells or equivalent, although useful in the laboratory assessment of iron deficiency anaemia ( IDA ), are confounded by thalassaemia trait ( TT ). We aim to evaluate the new red cell parameters on the Beckman Coulter DxH800 in distinguishing between IDA and TT . Methods A total of 246 normal subjects, 102 patients with IDA and 115 subjects with TT were accrued for the study. The parameters studied were red blood cell size factor ( RSF ), low haemoglobin density ( LHD %), microcytic anaemia factor ( MAF ), standard deviation of conductivity of the nonreticulocyte population ( SD ‐C‐ NRET ) and unghosted cell ( UGC ). Comparison between groups was performed by Student's t ‐test, and the diagnostic performance was determined by receiver operating characteristic ( ROC ) curve analysis. Results Both the LHD % and RSF were significantly higher in IDA than TT , whereas MAF and SD ‐C‐ NRET were significantly lower. The SD ‐C‐ NRET showed the best diagnostic performance as a single parameter. A formula, [( RBC + Hb) × ( HCT + SD ‐C‐ NRET )]/ RDW ‐ SD , was devised to distinguish between IDA and TT . With a cut‐off value of 23, the area under the curve ( AUC ) was 0.995 (95% CI of 0.99–1.00), the sensitivity was 97%, and the specificity was 99.1%. Conclusions The new RBC parameters on Beckman Coulter DxH800 provide useful information in distinguishing between IDA and TT , which is important for clinical decision‐making and for streamlining laboratory testing. A new formula is devised that performs better than other discriminant functions in the literature.