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Diagnostic test performance of the Mentzer index in evaluating Saudi children with microcytosis
Arwa Althumairi1, Amani M AlQarni2, Nourah K Alkaltham2
1Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Insights
The Mentzer index is not reliable for differentiating iron deficiency anemia from thalassemia trait in children. This study found low sensitivity and specificity, questioning its clinical utility in Saudi Arabia.
Area of Science:
- Pediatric Hematology
- Clinical Diagnostics
- Global Health
Background:
- Anemia affects 39.8% globally, posing a significant public health challenge.
- Anemia is defined by low hemoglobin levels, with severity varying by age group.
- Accurate diagnosis is crucial for effective anemia management and treatment.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the Mentzer index.
- To differentiate between iron deficiency anemia and thalassemia trait in pediatric patients.
- To assess the reliability of the Mentzer index in a Saudi Arabian pediatric population.
Main Methods:
- Included 434 children (≤16 years) with microcytosis (MCV <80 FL).
- Utilized hemoglobin electrophoresis and iron profile for diagnosis.
- Excluded children with other hematological conditions.
Main Results:
- 181 children had thalassemia, and 345 had iron deficiency anemia.
- Mentzer index showed 74% sensitivity and 63% specificity for beta-thalassemia trait.
- Mentzer index showed 61% sensitivity and 36% specificity for iron deficiency anemia.
Conclusions:
- The Mentzer index demonstrates limited reliability in distinguishing iron deficiency anemia from thalassemia trait.
- Findings align with previous literature suggesting caution in its application.
- Further research may be needed to identify more accurate diagnostic tools for microcytic anemias.
Background:
Anemia is a global public health concern, affecting both developing and industrialized countries at a rate of 39.8%. It is defined by low hemoglobin concentration, and anemia varies in severity based on age: <11 g/dL (6-59 months), <11.5 g/dL (5-11 years), and < 12 g/dL (12-14 years).
Aim:
This study evaluates the Mentzer index's reliability in differentiating iron deficiency anemia from the thalassemia trait.
Methods:
A total of 434 children (≤16 years) with hemoglobin electrophoresis previously screened for microcytosis (MCV <80 FL) and an iron profile were included. Children with other hematological conditions were excluded.
Results:
Out of 434 children, 181 were diagnosed with thalassemia, and 345 had iron deficiency anemia. The Mentzer index showed 74% sensitivity and 63% specificity for the beta-thalassemia trait, with 61% sensitivity and 36% specificity for iron deficiency anemia. The beta-thalassemia trait group had the highest negative predictive value (98%), while iron deficiency anemia had the highest positive predictive value (79%).
Conclusion:
Our study, which is consistent with previous literature, suggests that the Mentzer index is not highly reliable in distinguishing iron deficiency anemia from the thalassemia trait among children in Saudi Arabia.
