Original Articles
31 March 2025
Vol. 19 No. 2 (2025)
https://doi.org/10.4081/itjm.2025.1892

Mentzer Index and Red Cell Distribution Width Index in differentiating iron deficiency anemia and β-thalassemia trait

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Mentzer index, RDWI, microcytic hypochromic anemia, iron deficiency anemia, β-thalassemia
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Authors

Rabab H. Elshaikh
rabab.mahmoud@asu.edu.om
https://orcid.org/0000-0003-0973-8661
Department of Medical Laboratory Sciences, College of Applied and Health Sciences, A’ Sharqiyah University, Ibra, Oman.
Ashok Kumar Sah
https://orcid.org/0000-0002-7762-4351
Department of Medical Laboratory Sciences, College of Applied and Health Sciences, A’ Sharqiyah University, Ibra, Oman.
Abdelrahman Mohamed Abukanna
Department of Medicine, College of Medicine, Northern Border University, Arar, Saudi Arabia.
Abdulrahman Algarni
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia.
Ammar Abdelmola
Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Gizan, Saudi Arabia.
Hussam Ali Osman
Faculty of Medical and Health Sciences, Liwa University, Abu Dhabi, United Arab Emirates.
Tagwa Yousif Elsayed Yousif
Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Gizan, Saudi Arabia.
Elryah I. Ali
Department of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia.
Hiba Ali
Medical Laboratory Sciences College, University of Gezira, Wad Medani, Sudan.
Ayman Hussein Alfeel
Department Medical Laboratory Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates.

The differentiation between iron deficiency anemia (IDA) and β-thalassemia trait (βTT) is essential for managing microcytic hypochromic anemia. Indices such as the Mentzer Index (MI) and Red Cell Distribution Width Index (RDWI) serve as cost-effective preliminary diagnostic tools. This study evaluates the reliability and diagnostic accuracy of these indices. This cross-sectional study included 200 patients with microcytic hypochromic anemia at Khartoum public hospitals in 2021. MI was calculated as mean corpuscular volume (MCV)/red blood cell (RBC) count, and RDWI as (MCV×RDW)/RBC. Sensitivity, specificity, and the Youden Index were determined. Results revealed that among 200 patients, 100 had IDA and 100 had βTT. Both groups showed microcytic hypochromic features, though RBC was slightly elevated in βTT. IDA patients had decreased serum iron, while hemoglobin (Hb) electrophoresis revealed increased HbA2 and HbF in βTT. MI showed a sensitivity of 90% (βTT) and 95% (IDA), with a specificity of 95% and 90%, respectively. RDWI had a sensitivity of 83% (βTT) and 96% (IDA), with a specificity of 96% and 83%. MI had a higher Youden Index (0.85 for βTT). In conclusion, both indices effectively differentiate IDA and βTT, but MI is the most reliable and cost-effective tool.

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Scopus
Google Scholar
Europe PMC
Ntaios G, Chatzinikolaou A, Saouli Z, et al. Discrimination indices as screening tests for beta-thalassemic trait. Blood 2007;110:3815. DOI: https://doi.org/10.1182/blood.V110.11.3815.3815
Elshaikh RH, Amir R, Ahmeide A, et al. Evaluation of the discrimination between beta-thalassemia trait and iron deficiency anemia using different indexes. IJBM 2022;12:375-9. DOI: https://doi.org/10.21103/Article12(3)_OA4
Tabassum S, Khakwani M, Fayyaz A, Taj N. Role of Mentzer index for differentiating iron deficiency anemia and beta thalassemia trait in pregnant women. Pak J Med Sci 2022;38:878-82. DOI: https://doi.org/10.12669/pjms.38.4.4635
Zaghloul A, Al-bukhari TAMA, Bajuaifer N, et al. Introduction of new formulas and evaluation of the previous red blood cell indices and formulas in the differentiation between beta thalassemia trait and iron deficiency anemia in the Makkah region. Hematology 2016;21:351-8. DOI: https://doi.org/10.1080/10245332.2015.1133753
Tayab MA, Hoq MA, Begum M. Cut off value of red cell distribution width (RDW) in screening and diagnosis of iron deficiency anemia and β thalassemia trait. DS Hosp J 2021;37:51-8. DOI: https://doi.org/10.3329/dshj.v37i1.59117
Munir A, Rahim A, Zafar F, et al. Diagnostic potential of haematological indices (Mentzer index and RDWI) to distinguish iron deficiency anemia and βTT. J Fatima Jinnah Med Univ 2024;18:78-81. DOI: https://doi.org/10.37018/JFJMU/7881
Sun A, Chang JY, Jin YT, Chiang CP. Differential diagnosis between iron deficiency anemia and thalassemia trait-induced anemia. J Dent Sci 2023;18:1963-4. DOI: https://doi.org/10.1016/j.jds.2023.07.036
Gorakshakar AC, Colah RB. Is RBC discrimination index suitable for differentiating between α- and β- thalassemias? Indian J Hum Genet 2011;17:115-6. DOI: https://doi.org/10.4103/0971-6866.92079
World Health Organization. Nutritional anaemias. 1968. Available from: https://iris.who.int/bitstream/handle/10665/40707/WHO_TRS_405.pdf?sequence=1&isAllowed=y.
Kumar A, Saha D, Kini J, et al. The role of discriminant functions in screening beta thalassemia trait and iron deficiency anemia among laboratory samples. J Lab Physicians 2017;3:195-201. DOI: https://doi.org/10.4103/0974-2727.208256
Düzenli Kar Y, Özdemir ZC, Emir B, Bör Ö. Erythrocyte indices as differential diagnostic biomarkers of iron deficiency anemia and thalassemia. J Pediatr Hematol Oncol 2020;42:208-13. DOI: https://doi.org/10.1097/MPH.0000000000001597
Mentzer WC Jr. Differentiation of iron deficiency from thalassaemia trait. Lancet 1973;1:882. DOI: https://doi.org/10.1016/S0140-6736(73)91446-3
Ehsani MA, Shahgholi E, Rahiminejad MS, et al. A new index for discrimination between iron deficiency anemia and beta-thalassemia minor: results in 284 patients. Pak J Biol Sci 2009;12:473-5. DOI: https://doi.org/10.3923/pjbs.2009.473.475
Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J 2005;47:458-72. DOI: https://doi.org/10.1002/bimj.200410135

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Mentzer Index and Red Cell Distribution Width Index in differentiating iron deficiency anemia and β-thalassemia trait. (2025). Italian Journal of Medicine, 19(2). https://doi.org/10.4081/itjm.2025.1892
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