Demir eksikliği anemisi ve talasemi tanısında hematolojik indekslerin karşılaştırılması: Türkiye'de retrospektif bir çalışma

Abstract

Amaç: Demir eksikliği anemisi (DEA) ve beta-talasemi (β-TM) arasındaki doğru klinik ayrım, hastalık yönetimi ve etkili tedavi stratejilerinin belirlenmesi için kritik öneme sahiptir. Bu doğrultuda, bu çalışmada DEA ve talasemi arasındaki tanısal ayrım için kullanılan laboratuvar yöntemlerini ve hematolojik indeksleri karşılaştırmalı olarak değerlendirmeyi amaçladık. Çalışmada, DEA ve talaseminin rutin biyokimya analizleri arasındaki farklar ve bu hastalıkların teşhisinde kullanılan sekiz farklı indeksin etkinliği incelenmiştir. Gereç ve Yöntemler: DEA ve β-TM Minör tanısı alan hastaların rutin hematolojik parametreleri retrospektif olarak analiz edildi. Menzier İndeksi (MI), Green and King İndeksi (G&K), England and Fraser İndeksi (E&F), Kırmızı Kan Hücresi Dağılım Genişliği İndeksi (RDWI), Ricarca İndeksi (RI), Srivastava İndeksi (S), Sirdah İndeksi (SI) ve Ehsani İndeksi hesaplandı ve tanısal etkinlikleri değerlendirildi. Bulgular: Sekiz ayrım indeksi değerlendirildiğinde, G&K ve E&F indeksleri IDA ve β-TM'yi ayırt etmede en etkili indekslerdi. Bu indeksler sırasıyla %81,41 ve %80,24 Youden indeks değerleri ile yüksek duyarlılık ve özgüllük oranları gösterdi. Diğer ayırıcı indeksin karşılaştırmalı değerlendirmesi sonucunda, IDA ile β-TM’nin ayırt edilmesinde tanısal performans sırası G&K > E&F > SI > RDWI > RI > MI > E > S > RBC olarak saptanmıştır. Sonuç: Çeşitli hematolojik indekslerin kullanılması DEA ve β-TM ayrımında tanısal doğruluğu artırmaktadır. Özellikle G&K ve E&F indeksleri doğru tanıyı kolaylaştırabilir ve daha etkili klinik yönetim süreçlerine olanak sağlayabilir.

Keywords

• Demir eksikliği anemisi
• beta-talasemi
• hematolojik indeks
• kırmızı kan hücresi indeksleri
• eritrosit parametreleri

Ethical Statement

Çalışma, Kahramanmaraş Sütçü İmam Üniversitesi Tıp Araştırmaları Etik Kurulu tarafından 2025/05-388 protokol numarasıyla onaylanmıştır.

Comparison of haematological indices in diagnosing iron deficiency anaemia and thalassaemia: a retrospective study in Turkey

Abstract

Aim: Accurate clinical differentiation between Iron Deficiency Anemia (IDA) and beta-thalassemia (β-TM) is critical for disease management and the determination of effective treatment strategies. Accordingly, in this study, we aimed to comparatively evaluate the laboratory methods and hematologic indices used for the diagnostic differentiation between IDA and thalassemia. The study examined the differences between routine biochemistry analyses of IDA and thalassemia and the effectiveness of eight different indices used to diagnose these diseases. Material and Methods: Routine hematological parameters of patients diagnosed with IDA and β-TM Minor were analyzed retrospectively. Menzier Index (MI), Green and King Index (G&K), England and Fraser Index (E&F), Red Blood Cell Distribution Width Index (RDWI), Ricarca Index (RI), Srivastava Index (S), Sirdah Index (SI), and Ehsani Index were calculated and their diagnostic efficiency was evaluated. Results: When eight discrimination indices were evaluated, G&K and E&F indices were the most effective in differentiating IDA and β-TM. These indices showed high sensitivity and specificity rates with Youden index values of 81.41% and 80.24%, respectively. As a result of the comparative evaluation of other discriminatory indices, the diagnostic performance order for distinguishing between IDA and β-TM was determined to be G&K > E&F > SI > RDWI > RI > MI > E > S > RBC. Conclusion: Using various hematologic indices increases the diagnostic accuracy in differentiating IDA and β-TM. In particular, G&K and E&F indices may facilitate accurate diagnosis and enable more effective clinical management processes.

Keywords

• Iron deficiency anemia
• beta-thalassemia
• hematologic index
• red blood cell indices
• erythrocyte parameters

Ethical Statement

The study was approved by Kahramanmaraş Sütçü İmam University Medical Research Ethics Committee with protocol number 2025/05-388.

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