Lin Chung-King, Chen Ling-Ping, Chang Hsiu-Lin, Sung Yung-Chuan
Division of Hematology-Oncology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Division of Hematology-Oncology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan; Department of Internal Medicine, Medical College, Fujen Catholic University, Taipei, Taiwan.
Kaohsiung J Med Sci. 2014 Aug;30(8):409-14. doi: 10.1016/j.kjms.2014.03.010. Epub 2014 Apr 24.
Some physicians neglect the possible coexistence of an iron deficiency with a thalassemia minor and do not treat the iron deficiency accordingly. This motivated us to conduct this study. We retrospectively reviewed the records of 3892 patients who visited our clinics and had hemoglobin (Hb) electrophoreses performed in our hematologic laboratory from August 1, 2007 to December 31, 2012. The thalassemia minors were identified by characteristic complete blood count (CBC) parameters obtained from an autoanalyzer and Hb electrophoresis, and some cases were confirmed with molecular tests. Then, we checked iron studies [ferritin and/or serum iron with total iron-binding capacity (TIBC)] to determine the coexistence of an iron deficiency with a thalassemia minor and a response to iron, if such treatments were given. We found 792 cases with thalassemia minors, and excluded those without iron studies, with 661 cases as our sample. A total of 202/661 cases (31%) also had iron deficiencies. They had lower red blood cell (RBC) counts, Hb, and ferritin levels as compared to those thalassemia minor cases without coexistence of iron deficiencies. We concluded that the thalassemia minor patients did not have iron overload complications in our population. On the contrary, iron deficiencies commonly coexist in the clinical visits. We propose that if Hb < 11.5 g/dL in a case of thalassemia minor, one should screen for iron deficiency simultaneously. The sensitivity is 79.8% and the specificity is 82.6%. Therefore, physicians should be aware of this coexisting condition, and know how to recognize and treat it accordingly.
一些医生忽视了缺铁与轻度地中海贫血可能并存的情况，因此未对缺铁进行相应治疗。这促使我们开展了这项研究。我们回顾性分析了2007年8月1日至2012年12月31日期间到我们诊所就诊并在我们血液学实验室进行血红蛋白（Hb）电泳的3892例患者的记录。通过自动分析仪获得的特征性全血细胞计数（CBC）参数和Hb电泳来识别轻度地中海贫血患者，部分病例通过分子检测得以确诊。然后，我们检查了铁代谢指标[铁蛋白和/或血清铁及总铁结合力（TIBC）]，以确定缺铁与轻度地中海贫血是否并存，以及如果进行了此类治疗，对铁的反应情况。我们发现了792例轻度地中海贫血患者，并排除了那些未进行铁代谢指标检查的患者，最终选取661例作为我们的样本。共有202/661例（31%）同时存在缺铁情况。与那些不同时存在缺铁的轻度地中海贫血病例相比，他们的红细胞（RBC）计数、Hb和铁蛋白水平更低。我们得出结论，在我们的研究人群中，轻度地中海贫血患者没有铁过载并发症。相反，在临床就诊中缺铁情况普遍并存。我们建议，如果轻度地中海贫血患者的Hb<11.5 g/dL，应同时筛查缺铁情况。其敏感性为79.8%，特异性为82.6%。因此，医生应了解这种并存情况，并知道如何识别和相应地进行治疗。
