How are iron deficiency and non–transfusion-dependent thalassemia differentiated with lab tests?

Updated: Nov 26, 2019
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Patients with iron deficiency and those with undiagnosed non–transfusion-dependent thalassemia may present similarly. Although the two conditions can be differentiated by hemoglobin typing and iron studies, Piriyakhuntorn et al propose that red cell distribution width values (RDW) can provide a rapid and accurate distinction. They report that an RDW cut-off value of 21.0% (with lower values indicating iron deficiency and higher values indicating non–transfusion-dependent thalassemia) provided a sensitivity of 84.5%, specificity of 70.6%, positive predictive value of 83.1%, and negative predictive value of 72.7%. [13]

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