Effective screening for double heterozygosity of Hb E/alpha0-thalassemia

Ann Hematol. 2008 Nov;87(11):911-4. doi: 10.1007/s00277-008-0520-x. Epub 2008 Jun 25.

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/alpha(o)-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 alpha(o)-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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Erythrocyte Indices*
  • Female
  • Genetic Carrier Screening / methods*
  • Hemoglobin E* / analysis
  • Hemoglobin E* / genetics
  • Humans
  • Mass Screening / methods
  • Pregnancy
  • Prenatal Diagnosis / methods*
  • Reference Values
  • Sensitivity and Specificity
  • alpha-Thalassemia / genetics*

Substances

  • Hemoglobin E