Original Articles
31 March 2025
Early Access
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 College, Abu Dhabi, United Arab Emirates.
Tagwa Yousif Elsayed Yousif
Faculty of Medical and Health Sciences, Liwa College, Abu Dhabi, United Arab Emirates.
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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Mentzer Index and Red Cell Distribution Width Index in differentiating iron deficiency anemia and β-thalassemia trait. (2025). Italian Journal of Medicine. https://doi.org/10.4081/itjm.2025.1892
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