title: Study of parents of β-thalassemia major children to determine cutoff values of hematological parameters for diagnosis of β-thalassemia trait and assessment of anemia in them.
abstract: BACKGROUND
  Because of the overlapping MCV, MCH and HbA 2 values in BTT and non-BTT subjects our laboratory determined own cutoffs.
  
  
  OBJECTIVE
  To establish cutoff values by investigating the parents of thalassemia major children and to assess the degree of anemia in BTT subjects.
  
  
  METHODS
  Study includes 179 parents of thalassemia major children (BTT cases) and 287 non-BTT controls. Samples were analyzed on an electronic hematology analyzer. The samples having MCV ≤ 76 fl and MCH ≤ 27 pg were quantified for HbA 2 by cellulose acetate electrophoresis and grey zone samples were confirmed on HPLC. Statistical Analysis Mean ± SD, sensitivity, specificity, PPV, NPV and accuracy were calculated. The histograms were plotted for MCV, MCH and HbA 2 .
  
  
  RESULTS
  Cases having MCV ≤ 76 fl and MCH ≤ 27 pg if considered as suspected cases of BTT then we could have missed five known BTT samples. Sensitivity increased to 100% in all three diagnostic parameters when the cutoff values were raised and specificity for MCV and MCH was decreased. But specificity was 100% with raised cutoff for HbA 2 . Hb and HCT mean values were significantly reduced in BTT cases compared to controls (P < 0.001). In 100% females and 84.9% males having BTT, mild to moderate anemia was observed.
  
  
  CONCLUSIONS
  In our setup, the cutoff values are MCV (≤78.0 fl), MCH (≤28 pg) and HbA 2 (>3.8%) for BTT diagnosis and there is a mild to moderate anemia in BTT cases.
authors: Department of Hemoglobinopathy, Surat Raktadan Kendra and Research Centre, NABH Accredited Regional Blood Transfusion Centre, Surat, Gujarat, India.
authors: Dipal
authors: D
authors: Bhukhanvala
authors: Vijeta
authors: V
authors: Seliya
authors: Avani
authors: A
authors: Shah
authors: Snehalata
authors: S
authors: Gupte
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood; D016022:Case-Control Studies; D004909:Erythrocyte Indices; D005260:Female; D006443:Hemoglobin A2 / Q000378:metabolism*; D006801:Humans; D008297:Male; D010290:Parents; D011237:Predictive Value of Tests; D017086:beta-Thalassemia / Q000097:blood* / Q000175:diagnosis*
chemical_list: D006443:Hemoglobin A2