title: δβ-Thalassemia trait: how can we discriminate it from β-thalassemia trait and iron deficiency anemia?
abstract: OBJECTIVE
  To analyze the differences not only in classic hematologic parameters but also in RBC subpopulations among δβ-thalassemia trait (δβ-TT), β-thalassemia trait (β-TT), and iron deficiency anemia (IDA) and to evaluate the role of fetal hemoglobin (HbF) in elevated RBC distribution width (RDW).
  
  
  METHODS
  Samples from 553 patients with microcytosis (74 δβ-TT, 272 β-TT, and 207 IDA) were run on an Advia 2120i analyzer (Siemens Medical Solutions Diagnostics, Tarrytown, NY). Classic hematologic parameters and RBC subpopulations were assessed. The correlation between HbF and RDW in patients with thalassemia (both β and δβ) was evaluated. An independent sample t test was used to compare classic hematologic parameters and RBC subpopulations among β-TT, IDA, and δβ-TT and receiver operating characteristic curves performed in the significant comparisons.
  
  
  RESULTS
  RDW was significantly higher in δβ-TT compared with β-TT (18.79% vs 16.04%, P < .001), as was mean corpuscular volume (66.39 vs 64.82 fL, P < .001), mean corpuscular hemoglobin (20.73 vs 20.04 pg, P < .001), and mean corpuscular hemoglobin concentration (31.16 vs 30.66 g/dL, P = .03). Pearson coefficient showed a good correlation between HbF and RDW. The values obtained for all the parameters were significantly different (P < .001) between patients with thalassemia (β and δβ) and IDA.
  
  
  CONCLUSIONS
  RDW is the best parameter to discriminate δβ-TT from β-TT. The degree of anisocytosis in patients with β-TT and δβ-TT is strongly correlated with HbF.
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and diegovelascorodriguez@gmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Velasco-Rodríguez
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and.
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Alonso-Domínguez
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Fernando-Ataúlfo
authors.initials: FA
authors.lastname: González-Fernández
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and.
authors.forename: Jesús
authors.initials: J
authors.lastname: Villarrubia
authors.affiliation: Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Ropero
authors.affiliation: Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Martínez-Nieto
authors.affiliation: Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: de la Fuente
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and.
authors.forename: Raquel
authors.initials: R
authors.lastname: Guillén
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and.
authors.forename: Natalia
authors.initials: N
authors.lastname: Acedo
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and.
authors.forename: Cristina
authors.initials: C
authors.lastname: Serí
authors.affiliation: From the Laboratorio Central de la Comunidad de Madrid, Madrid, Spain, and.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cava
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology; D005319:Fetal Hemoglobin / Q000378:metabolism; D006801:Humans; D013789:Thalassemia / Q000097:blood / Q000175:diagnosis*; D017086:beta-Thalassemia / Q000097:blood / Q000175:diagnosis; D055538:delta-Thalassemia / Q000097:blood / Q000175:diagnosis
chemical_list: D005319:Fetal Hemoglobin
keywords: Differential diagnosis; Microcytic anemia; Thalassemia; β; δ