Determining the diagnostic accuracy of red cell distribution width in the differential diagnosis of iron deficiency anemia and non-transfusion dependent beta thalassemia

Ghazala Qamar; Mavra Fatima; Ayisha Imran

doi:10.5455/JELM.20240611073520

Abstract
Background: Hypochromic microcytic anemia comprises the major chunk of red blood-related disorders in our part of the world. Iron deficiency and beta thalassemia are the most common hypochromic/microcytic anemia. Red cell distribution width (RDW) is a credible marker of variation in red cell size (anisocytosis). RDW is usually elevated in iron deficiency anemia (IDA) due to variations in the size of erythrocytes while it is normal in the beta thalassemia trait (TT). Therefore, it is of considerable significance in the detection of IDA in clinical conditions, where iron studies and ther specialized investigations cannot be undertaken due to the reason of resource constraints.
Aim: The study aims to detect the sensitivity and specificity of RDW in IDA and beta TT. Hence, RDW is cost-effective and a reliable parameter in detecting IDA in the absence of many other diagnostic choices.
Methods: The study was conducted at Chughtai Institute of Pathology Lahore from September 2019–November 2019. It was a cross-sectional prospective study including 115 patients and dividing them into two main groups. Group 1 included patients of IDA. Group 2 included patients with beta TT having hemoglobin A2 values of >3.5 diagnosed on capillary hemoglobin electrophoresis.
Results: The overall age of patients was 28.5 ± 9.5 years and 30 (26.1%) were males. Thirty-one (27.0%) were diagnosed as βTT among them. RDW had a sensitivity of 83.9% and specificity of 91.7% in the diagnosis of βTT by differentiating from IDA.
Conclusion: RDW is a reliable and useful index for the diagnosis of IDA and differentiates it from βTT.

Key words: Red cell distribution width; iron deficiency; thalassemia; anisocytosis; hypochromic; microcytic