DIFFERENCE OF HET RE LEVEL IN THALASSEMIA Β MINOR AND IRON DEFICIENCY ANEMIA

Abstract

Background The most common diseases found with peripheral blood morphological features of hypochromic microcytic anemia are iron deficiency anemia and thalassemia. Hypochrome micrositer is a morphological description of red blood cells with MCV values smaller than normal (<80fl) and MCH smaller than normal values (<27pq). This morphological picture can be found in the condition of iron deficiency anemia and thalassemia. There are several markers for the assessment of Hb content in reticulocytes, including Ret-He. Ret-He, which can be measured by the latest automated hematological analysis, is considered to reflect the iron content in reticulocytes

Aim Using Ret-He levels as a marker in distinguishing patients with β minor thalassemia and iron deficiency anemia.

Method This research is an observational analytic study using case control measurement method, during April to July 2019 at the Department of Clinical Pathology, Faculty of Medicine, University of North Sumatra / H. Adam Malik General Hospital Medan. The population was students who were admitted to the University of North Sumatra who came for complete blood count examination. The subjects were students with MCV <80 fl, MCH <27 pq. Subjects who met the inclusion criteria then continued with the calculation of the Mentzer Index and RDW Index, ferritin serum examination using the ECLIA method, hemoglobin electrophoresis examination with micro capillary electrophoresis. By consecutive sampling, 42 samples were obtained, of which 21 subjects diagnosed with iron deficiency anemia and 21 subjects diagnosed with beta thalassemia minor were examined for their RetHe levels using the flowsitometric method which were then analyzed statistically.

Results From 21 iron deficiency anemia patients it was found that the average Ret-He value was 30.64 (6.08) pg and from 21 patients with beta minor thalassemia it was found that the average Ret-He value was 25.63 (6 , 72) pg. The results of the unpaired t-test for both groups obtained p = 0.016. By using the ROC curve obtained the Ret-He cut-off value in distinguishing cases of iron deficiency anemia with thalassemia was 27.30 pg with a sensitivity of 90.5% and specificity of 71.4%.

Conclusion From the results of the study concluded that there was a significant difference between the levels of Ret-He in patients with iron deficiency anemia with thalassemia beta minor patients with a cut-off value of 27.30pg