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Effective screening for double heterozygosity of Hb E/α0-thalassemia

Annals of Hematology volume 87, pages 911–914 (2008)Cite this article

Abstract

One hundred and forty-one blood samples of hemoglobin E (Hb E) carriers were collected to define suitable cutoff values of Hb E level, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) as screening indicators for detecting individuals with double heterozygosity for Hb E/αo-thalassemia. Based on the values that gave 100% sensitivity, Hb E < 26%, MCV < 74 fl, and MCH < 24 pg were selected. Further validation of these selected values in additional 152 heterozygous Hb E pregnant women revealed 100% sensitivity, 86.2% specificity, and a 25.9% positive predictive value (PPV) for using Hb E cutoff point only, meanwhile, 100% sensitivity, 83.4% specificity, and 22.6% PPV were achieved for the MCV cutoff point. In addition, 100% sensitivity, 86.3% specificity, and 25.9% PPV were gained for the MCH cutoff point. Combining Hb E level with either MCV or MCH cutoff points, the specificity and PPV were increased to 95.1% and 50.0%, respectively. It is concluded that Hb E level < 26%, MCV < 74 fl, and MCH < 24 pg could be used for screening αo-thalassemia in heterozygous Hb E. However, to improve specificity and PPV of the tests, a combination of Hb E level < 26% with either MCV < 74 fl or MCH < 24 pg is recommended.

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Acknowledgements

We thank Prof. Frank P. Schelp for helpful comments on the manuscript.

This work was supported in part by a grant from Khon Kaen University, Khon Kaen, Thailand.

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Affiliations

  1. Faculty of Associated Medical Sciences, Centre for Research and Development of Medical Diagnostic Laboratories, Khon Kaen University, Khon Kaen, 40002, Thailand

    Kanokwan Sanchaisuriya, Sunisa Chirakul, Hataichanok Srivorakun, Goonnapa Fucharoen & Supan Fucharoen

  2. Clinical Microscopy Unit, Faculty of Medicine, Srinagarind Hospital, Khon Kaen, Thailand

    Yossombat Changtrakul

  3. Department of Nutrition, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand

    Pattara Sanchaisuriya

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  1. Kanokwan Sanchaisuriya
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  2. Sunisa Chirakul
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  3. Hataichanok Srivorakun
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  4. Goonnapa Fucharoen
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  5. Supan Fucharoen
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  6. Yossombat Changtrakul
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  7. Pattara Sanchaisuriya
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Correspondence to Kanokwan Sanchaisuriya.

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Sanchaisuriya, K., Chirakul, S., Srivorakun, H. et al. Effective screening for double heterozygosity of Hb E/α0-thalassemia. Ann Hematol 87, 911–914 (2008). https://doi.org/10.1007/s00277-008-0520-x

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  • DOI: https://doi.org/10.1007/s00277-008-0520-x

Keywords

  • Hemoglobin E
  • Alpha-thalassemia
  • Screening strategy
  • RBC indices