Thalassemia: Likelihood Ratios

Introduction: Thalassemia is in the differential diagnosis of a microcytic anemia. The two other categories of microcytic anemia are Iron Deficiency Anemia and Anemia of Chronic Disease. There are a number of different 'indices' that one can use to distinguish IDA from thalassemia (see below), but iron studies / ferritin are probably more accurate.

I have chosen to simply paste in references here because the numbers are rather discordant among the studies.

J Trop Pediatr. 2007 Apr;53(2):93-7. PMID: 17166936

J Int Med Res. 2009 Jan-Feb;37(1):25-30. PMID: 19215670

Pediatr Int. 2002 Dec;44(6):612-6. PMID: 12421257

Ann Hematol. 2007 Jul;86(7):487-91. PMID: 17476506

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Differential Diagnoses include: Iron Deficiency Anemia

The likelihood ratios of findings for Thalassemia are listed below. See the left navigation bar to change the display.

Findings With Unspecified Accuracy

Finding	+LR	-LR	Comments, Study
England and Fraser Index	No accuracy specified.		Study: no study specified.
Shine and Lal Index	No accuracy specified.		Study: no study specified.
RDW, decreased	No accuracy specified.		in thalassemia, the RDW tends to be normal to decreased (whereas it tends to be increased in iron deficiency) Study: no study specified.
Mentzer index	No accuracy specified.		Study: no study specified.
Srivastava Index	No accuracy specified.		Study: no study specified.
Green and King Index	No accuracy specified.		Study: no study specified.