Efficacy of Mentzer Index and Red Cell Distribution Width as Discriminatory Indices Between Beta-Thalassemia Carrier State and Iron Deficiency Anemia: A Study of 150 Cases
Keywords:
Iron deficiency anemia, Beta-thalassemia carrier state, Mentzer Index, Red cell distribution width, Microcytic hypochromic anemia, Red blood cell indices, Screening indices, Complete blood countAbstract
Background: Microcytic hypochromic anemia is a common hematological finding, particularly in developing countries. The two most frequent causes are iron deficiency anemia (IDA) and beta-thalassemia carrier state (beta-thalassemia trait, BTT). Differentiation between these two conditions is essential, as their management, prognosis, and genetic counseling implications differ significantly. Simple red cell indices derived from complete blood count (CBC), such as the Mentzer Index and Red Cell Distribution Width (RDW), are widely used as screening tools in resource-limited settings.
Objective: To evaluate the diagnostic efficacy of the Mentzer Index and RDW in distinguishing beta-thalassemia carrier state from iron deficiency anemia.
Methods: This cross-sectional analytical study was conducted on 150 patients presenting with microcytic hypochromic anemia. Complete blood count parameters were obtained using an automated hematology analyzer. Mentzer Index was calculated as mean corpuscular volume divided by red blood cell count. RDW values were recorded directly from analyzer reports. Iron deficiency anemia was confirmed by low serum ferritin levels, while beta-thalassemia carrier state was diagnosed based on elevated HbA2
levels on hemoglobin electrophoresis or high-performance liquid chromatography. The diagnostic performance of the Mentzer Index and RDW was assessed by calculating sensitivity and specificity.
Results: Out of 150 cases, 90 (60%) were diagnosed with iron deficiency anemia and 60 (40%) with beta-thalassemia carrier state. Mean Mentzer Index values were significantly higher in iron deficiency anemia, while beta-thalassemia carriers showed lower values. A Mentzer Index cutoff less than 13 demonstrated high sensitivity and specificity for identifying the beta-thalassemia carrier state. RDW values were significantly elevated in iron deficiency anemia compared to beta-thalassemia carriers, showing high sensitivity for detecting iron deficiency anemia. Combined use of both indices improved diagnostic accuracy.
Conclusion: Mentzer Index and RDW are simple, cost-effective, and reliable screening tools for differentiating IDA from beta-thalassemia carrier state, particularly in low-resource settings.
Mediscope 2026;13(2): 105-110
0
0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Abdullah Al Faroque, Tasnim Rahman, Syeda Noorjahan Karim, F M Khaliduzzaman
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in the Mediscope agree to the following terms that:
- Authors retain copyright and grant Mediscope the right of first publication of the work.
Articles in Mediscope are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0. This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.
