ISSN 2997-1036
International Journal of Hematology | Vol. 2, No. 9, September 2011 | pp. 65–72
DOI: 10.46882/2011/IJH/000021
Original Article
Title: Diagnostic accuracy of cell counter-derived microcytic anemia indices compared with gold standard bone marrow iron stores
Names of Authors: A. I. Mustapha¹, C. K. Nwosu², E. O. Olayinka³
Authors’ Affiliations: ¹Department of Haematology, University of Ilorin Teaching Hospital, Ilorin, Nigeria; ²Department of Pathology, Enugu State University of Science and Technology, Enugu, Nigeria; ³Department of Biomedical Science, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Differentiating absolute iron deficiency from other microcytic disorders remains critical for targeted therapeutic planning. This prospective study evaluated the diagnostic accuracy of the Green and King index, Mentzer index, and red blood cell distribution width against histological bone marrow iron grading using Perl’s Prussian blue stain. Bone marrow aspirates and peripheral blood counts were obtained from 115 adult patients with microcytic hypochromic anemia (MCV < 80 fl). Histological examination confirmed absent bone marrow iron stores in 58.3% (67 of 115) of the patients. The Mentzer index exhibited a sensitivity of 76.1% and a specificity of 70.8% for diagnosing absolute iron deficiency. The Green and King index demonstrated superior diagnostic performance, yielding a sensitivity of 89.6%, a specificity of 85.4%, and an area under the receiver operating characteristic curve of 0.88 (P < 0.001). Combining automated red blood cell distribution width with the Green and King mathematical model significantly reduced misclassification rates compared to single-parameter indices. These results demonstrate that utilizing refined cell counter-derived mathematical formulas provides an accessible, non-invasive, and reliable screening protocol for iron deficiency in laboratories lacking advanced biochemical profiles.
Keywords: Iron deficiency anemia, bone marrow iron, Mentzer index, Green and King index, microcytosis
Manuscript Timeline: Received: June 10, 2011; Revised: July 15, 2011; Accepted: August 04, 2011; Published: September 12, 2011