Oral Presentation Indian Ocean Rim Laboratory Haematology Congress 2019

A comparison study of red blood cells parameters between southeast Asian ovalocytosis (sao) alone and sao with concomitant iron deficiency anaemia (#18)

Hafizuddin Bin Mohamed Fauzi 1 , Nik Shaida Binti Shamim Nik 1 , Ernest Mangantig 1 , Narazah Binti Mohd Yusoff 1 , Mohd Nazri Bin Hassan 2 , Ammar Rashidi Bin Abdullah 3
  1. Renerative Medicine Cluster, Institut Perubatan Dan Pergigian Termaju, Universiti Sains Malaysia, Kepala Batas, Malaysia
  2. Deparment of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
  3. Hospital Kepala Batas, Kepala Batas, Malaysia

Introduction: Southeast Asian Ovalocytosis (SAO) and Iron Deficiency Anaemia (IDA) are common in Malaysia. They have specific RBC parameters pattern but overlapping morphological features. When SAO patients having concomitant IDA, it is challenging to differentiate this with SAO alone. Thus, the study aims to study potential RBC parameters that able to discriminate them.

Methodology: A retrospective cross-sectional study was conducted among 49 subjects from Institut Perubatan dan Pergigian (IPPT), Universiti Sains Malaysia (30 cases with SAO alone and 19 cases SAO with concomitant IDA). The data were obtained from the Laboratory Information System of Advanced Diagnostic Laboratory from January 2010 to May 2019. Univariable analysis (Mann-Whitney) was used to compare the red blood cell parameters between the two groups, which include RBC count, Haemoglobin level, MCV, MCH, MCHC and RDW. Statistical significance was set at a p-value of  < 0.05.

Results: SAO with concomitant IDA showed median (IQR) of RBC,Haemoglobin, MCV, MCH, MCHC and RDW of 3.53 x 106/μL (1.7), 8.7 g/dL (4.3), 74.6 fL (9.4), 25.7 pg (6.9), 33.7g/dL (5.2) and 46.0 fL (7.2) respectively. It was found that the Haemoglobin level (p-value = 3.0 x 10-3), MCV (p-value = 2.4 x 10-4) and MCH (p-value = 3.0 x 10-3) of SAO with concomitant IDA group were significantly lower compared to the SAO alone group. However, the RBC count, MCHC and RDW parameters were not significant between both groups (p > 0.05).

Conclusion: Three RBC parameters, namely Haemoglobin, MCV and MCH, were shown to be potential to discriminate between patients SAO with concomitant IDA and SAO alone. Therefore, in the absence of advanced parameters, these three basic parameters may be potentially used to guide ordering of iron profile for confirmatory diagnosis of IDA. The larger sample size is needed to confirm the result.