Cargando…

Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup

Introduction: Thalassemia and hemoglobinopathies are the most common inherited hematological disorders. Of these, β thalassemia is the commonest disorder reported in India, followed by certain hemoglobinopathies encountered in different regions of the country. The data pertaining to the incidence of...

Descripción completa

Detalles Bibliográficos
Autores principales: Singh, Neha, Chowdhury, Nilotpal, Bahadur, Anupama, Ahuja, Sana, Arathi, Kunnumbrath, Jeladharan, Reshma, Mirza, Anissa A, Gupta, Arvind K, Chandra, Harish, Rao, Shalinee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10356969/
https://www.ncbi.nlm.nih.gov/pubmed/37485171
http://dx.doi.org/10.7759/cureus.40667
_version_ 1785075393140621312
author Singh, Neha
Chowdhury, Nilotpal
Bahadur, Anupama
Ahuja, Sana
Arathi, Kunnumbrath
Jeladharan, Reshma
Mirza, Anissa A
Gupta, Arvind K
Chandra, Harish
Rao, Shalinee
author_facet Singh, Neha
Chowdhury, Nilotpal
Bahadur, Anupama
Ahuja, Sana
Arathi, Kunnumbrath
Jeladharan, Reshma
Mirza, Anissa A
Gupta, Arvind K
Chandra, Harish
Rao, Shalinee
author_sort Singh, Neha
collection PubMed
description Introduction: Thalassemia and hemoglobinopathies are the most common inherited hematological disorders. Of these, β thalassemia is the commonest disorder reported in India, followed by certain hemoglobinopathies encountered in different regions of the country. The data pertaining to the incidence of these disorders in the Uttarakhand region of India are sparse. Aim and objectives: To ascertain the prevalence and spectrum of thalassemia/hemoglobinopathies amongst antenatal women in Uttarakhand. The study also aimed to analyze the ability of red cell indices in differentiating beta thalassemia trait (BTT) from mild iron deficiency anemia (IDA). Material and methods: A total of 460 pregnant women in the first trimester of pregnancy were screened by cation exchange high-performance liquid chromatography. Retention time and proportions of normal/abnormal hemoglobin peaks were documented in all cases. Hemoglobin A2 (HbA2) values of ≥4% were taken as a cut-off for diagnosing BTT. Blood samples were also collected for complete blood counts, reticulocyte counts, and serum ferritin. The ability of the various discriminatory indices to differentiate between IDA and BTT was also assessed. Results: The prevalence of BTT and hemoglobin D-Punjab trait amongst pregnant women was found to be 2.6% and 0.2%, respectively. RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were found to be moderately strong predictors of BTT, with an area under the curve of 0.860, 0.857, and 0.842, respectively, which were comparable to the discriminatory indices found to be most useful in this study. Conclusion: In view of the 2.6% prevalence of BTT in antenatal women in this region of Uttarakhand, a routine screening will be helpful in detecting carriers early in the antenatal period. Careful interpretation of red cell indices is crucial to the distinction between BTT and IDA. Discriminatory indices are reasonably accurate in differentiating BTT from mild iron deficiency, but for practical purposes, MCV and MCH provide equivalent information to identify cases that require further workup.
format Online
Article
Text
id pubmed-10356969
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-103569692023-07-21 Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup Singh, Neha Chowdhury, Nilotpal Bahadur, Anupama Ahuja, Sana Arathi, Kunnumbrath Jeladharan, Reshma Mirza, Anissa A Gupta, Arvind K Chandra, Harish Rao, Shalinee Cureus Pathology Introduction: Thalassemia and hemoglobinopathies are the most common inherited hematological disorders. Of these, β thalassemia is the commonest disorder reported in India, followed by certain hemoglobinopathies encountered in different regions of the country. The data pertaining to the incidence of these disorders in the Uttarakhand region of India are sparse. Aim and objectives: To ascertain the prevalence and spectrum of thalassemia/hemoglobinopathies amongst antenatal women in Uttarakhand. The study also aimed to analyze the ability of red cell indices in differentiating beta thalassemia trait (BTT) from mild iron deficiency anemia (IDA). Material and methods: A total of 460 pregnant women in the first trimester of pregnancy were screened by cation exchange high-performance liquid chromatography. Retention time and proportions of normal/abnormal hemoglobin peaks were documented in all cases. Hemoglobin A2 (HbA2) values of ≥4% were taken as a cut-off for diagnosing BTT. Blood samples were also collected for complete blood counts, reticulocyte counts, and serum ferritin. The ability of the various discriminatory indices to differentiate between IDA and BTT was also assessed. Results: The prevalence of BTT and hemoglobin D-Punjab trait amongst pregnant women was found to be 2.6% and 0.2%, respectively. RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were found to be moderately strong predictors of BTT, with an area under the curve of 0.860, 0.857, and 0.842, respectively, which were comparable to the discriminatory indices found to be most useful in this study. Conclusion: In view of the 2.6% prevalence of BTT in antenatal women in this region of Uttarakhand, a routine screening will be helpful in detecting carriers early in the antenatal period. Careful interpretation of red cell indices is crucial to the distinction between BTT and IDA. Discriminatory indices are reasonably accurate in differentiating BTT from mild iron deficiency, but for practical purposes, MCV and MCH provide equivalent information to identify cases that require further workup. Cureus 2023-06-19 /pmc/articles/PMC10356969/ /pubmed/37485171 http://dx.doi.org/10.7759/cureus.40667 Text en Copyright © 2023, Singh et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pathology
Singh, Neha
Chowdhury, Nilotpal
Bahadur, Anupama
Ahuja, Sana
Arathi, Kunnumbrath
Jeladharan, Reshma
Mirza, Anissa A
Gupta, Arvind K
Chandra, Harish
Rao, Shalinee
Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup
title Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup
title_full Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup
title_fullStr Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup
title_full_unstemmed Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup
title_short Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup
title_sort thalassemia and hemoglobinopathy screening in women attending antenatal clinic at a tertiary care center in uttarakhand, india: a re-look at the laboratory parameters mandating high-performance liquid chromatography workup
topic Pathology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10356969/
https://www.ncbi.nlm.nih.gov/pubmed/37485171
http://dx.doi.org/10.7759/cureus.40667
work_keys_str_mv AT singhneha thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT chowdhurynilotpal thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT bahaduranupama thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT ahujasana thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT arathikunnumbrath thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT jeladharanreshma thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT mirzaanissaa thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT guptaarvindk thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT chandraharish thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup
AT raoshalinee thalassemiaandhemoglobinopathyscreeninginwomenattendingantenatalclinicatatertiarycarecenterinuttarakhandindiaarelookatthelaboratoryparametersmandatinghighperformanceliquidchromatographyworkup