ISSN 2997-1036
International Journal of Hematology | Vol. 9, No. 12, December 2018 | pp. 89–96
DOI: 10.46882/2018/IJH/000108
Original Article
Title: Evaluation of automated reticulocyte maturation parameters and zinc protoporphyrin variants in separating iron deficiency from beta-thalassemia trait profiles
Names of Authors: Q. S. Abubakar¹, U. T. Maina²
Authors’ Affiliations: ¹Department of Haematology, National Hospital, Abuja, Nigeria; ²Department of Pathology, Bayero University, Kano, Nigeria
Abstract: Ineffective iron utilization and hemoglobin production variations generate overlapping microcytic red blood cell indices, requiring rapid laboratory differentiation models. This prospective diagnostic study evaluated the performance of automated immature reticulocyte fractions (IRF) and zinc protoporphyrin (ZPP) variants for separating absolute iron deficiency anemia from beta-thalassemia trait carriers. Evaluations were conducted on 135 adult patients presenting with persistent microcytosis (MCV < 76 fl). Diagnoses were validated using serum ferritin and high-performance liquid chromatography (HPLC) to measure hemoglobin A2 levels. Absolute iron deficiency was confirmed in 85 patients, while 50 were diagnosed with beta-thalassemia trait (HbA2 > 3.5%). The mean immature reticulocyte fraction was significantly higher in beta-thalassemia trait carriers compared to the iron-deficient cohort (0.28 ± 0.06 versus 0.12 ± 0.03, P < 0.001), reflecting an accelerated erythroid drive. Conversely, zinc protoporphyrin ratios were markedly elevated in absolute iron deficiency. Receiver operating characteristic analysis established a combined IRF and ZPP model that achieved a diagnostic sensitivity of 91.2% and a specificity of 88.4% for identifying thalassemia traits. Utilizing automated reticulocyte maturity indices provides an efficient, low-cost asset for screening inherited hemoglobin anomalies before completing advanced chromatography.
Keywords: Immature reticulocyte fraction, zinc protoporphyrin, iron deficiency anemia, beta-thalassemia trait, cell counter indices
Manuscript Timeline: Received: September 15, 2018; Revised: October 22, 2018; Accepted: November 11, 2018; Published: December 14, 2018