Detection of Latent Iron Deficiency and Thalassemia Trait with Red Cell Indices and Peripheral Blood Smear

Abstract

Objective: To evaluate the effectiveness of red cell indices and peripheral blood smear findings in detecting latent iron deficiency and differentiating it from thalassemia trait, and to determine the diagnostic accuracy of commonly used discrimination indices in distinguishing between these two causes of microcytosis.

Study Design: Observational cross-sectional study
Place and Duration of Study: This study was conducted at the Department of Pathology (Hematology) at Pakistan Railway Hospital (PRH), in collaboration with the Medicine, Surgery, and Gynecology/Obstetrics departments. The study was carried out over one year, from September 2023 to September 2024.

Methods: This study was conducted over one year and involved 285 adults referred from outpatient departments in medicine and surgery, with haemoglobin levels ranging from 10 to 12 g/dL. Participants included both males and females, with a predominant representation of young adults. Data collection focused on complete blood counts, red cell indices, and blood smear examinations.

Results: A total of 285 samples were collected and analyzed, comprising 50.9% male and 49.1% female participants, with a mean age of 24±3 years. Haematological parameters, including haemoglobin, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and red cell distribution width (RDW), were recorded. The findings revealed that 61.4% of participants were diagnosed with latent iron deficiency, while 38.6% were identified as having thalassemia trait on the basis of CBC and blood smears.

Conclusion: The data analysis revealed a high prevalence of latent iron deficiency, characterized by a hypochromic microcytic blood picture and low ferritin levels. In contrast, participants with thalassemia trait also exhibited microcytosis but typically had normal or elevated ferritin levels. Despite similar haematological features, the conditions stem from different causes.