{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:09:58Z","timestamp":1790014198841,"version":"4.0.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,4,23]],"date-time":"2014-04-23T00:00:00Z","timestamp":1398211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":496,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The potential impact of concomitant iron deficiency on hemoglobin A2 (HbA2)\u2010based identification of \u03b2\u2010thalassemia trait (\u03b2<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content>) is a worrisome issue for screening laboratories. This is especially true for resource\u2010constrained settings where iron deficiency is widespread and molecular confirmatory tests for borderline low HbA2 values may be unavailable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Obligate \u03b2<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> carrier individuals (<jats:italic>n<\/jats:italic>\u00a0=\u00a0752) were identified during screening studies on the parents of thalassemia major patients. HbA2%, complete blood counts and serum iron, ferritin and transferrin saturation were studied. Iron\u2010deficient individuals (<jats:italic>n<\/jats:italic>\u00a0=\u00a0135) with normal range HbA2% were taken as controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Concomitant iron deficiency (defined as ferritin \u226415\u00a0ng\/mL and\/or transferrin saturation \u226415%) was present in 20.7% (156\/752) \u03b2TT cases, that is, 33.3% females (122\/366) and 8.8% males with \u03b2TT (34\/386). Mean HbA2 in iron\u2010replete \u03b2TT was 5.4\u00a0\u00b1\u00a00.8 (range 3.1\u20137.9) and in iron\u2010deficient \u03b2TT was 5.4\u00a0\u00b1\u00a00.9 (range 3.3\u20137.6). HbA2\u00a0&lt;\u00a04.0% was found in 23\/752 (3.1%) \u03b2TT: 13\/595 iron\u2010replete (2.2%) and 10\/157 (6.4%) iron\u2010deficient \u03b2TT individuals. However, five of the 10 iron\u2010deficient \u03b2TT cases carried the silent CAP+1 (A&gt;C) \u03b2\u2010thalassemia allele accounting for the borderline HbA2%. On a separate analysis, all five severely anemic \u03b2TT (Hb\u00a0&lt;\u00a080\u00a0g\/L) and 16\/17 \u03b2TT with severe hypoferritinemia (&lt;5\u00a0ng\/mL) had HbA2\u00a0&gt;\u00a04.5%. The single case with serum ferritin 4.8\u00a0ng\/mL and HbA2 3.3% showed a CAP+1 (A&gt;C) mutation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Iron deficiency was prevalent among north Indian \u03b2<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> individuals, especially women. After adjusting for other causes of low HbA2 in \u03b2<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content>, iron deficiency, even when very severe, was very unlikely to interfere significantly with HbA2\u2010based identification of \u03b2<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.12246","type":"journal-article","created":{"date-parts":[[2014,4,23]],"date-time":"2014-04-23T07:48:00Z","timestamp":1398239280000},"page":"105-111","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Impact of iron deficiency on hemoglobin A2% in obligate \u03b2\u2010thalassemia heterozygotes"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4741-3403","authenticated-orcid":false,"given":"P.","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Trehan","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology Unit Department of Pediatrics Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Bansal","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology Unit Department of Pediatrics Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Marwaha","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology Unit Department of Pediatrics Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Garewal","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-553X.2011.01368.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470988787"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830240204"},{"key":"e_1_2_8_5_1","first-page":"55","article-title":"Red cell indices and discriminant functions in the detection of beta\u2010thalassaemia trait in a population with high prevalence of iron deficiency anaemia","volume":"42","author":"Madan N","year":"1999","journal-title":"Indian J Pathol Microbiol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-011-0088-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365519950186011"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2011.052357"},{"key":"e_1_2_8_9_1","first-page":"301","volume-title":"Dacie and Lewis Practical Haematology","author":"Wild BJ","year":"2011"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/03014460500075019"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2010.01422.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1990.tb07808.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(77)80880-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2011.696"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/858294"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2007.00958.x"}],"container-title":["International Journal of Laboratory Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijlh.12246","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.12246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:03:54Z","timestamp":1695567834000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijlh.12246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,23]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1111\/ijlh.12246"],"URL":"https:\/\/doi.org\/10.1111\/ijlh.12246","archive":["Portico"],"relation":{},"ISSN":["1751-5521","1751-553X"],"issn-type":[{"value":"1751-5521","type":"print"},{"value":"1751-553X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,23]]},"assertion":[{"value":"2014-04-23","name":"published_online","label":"Published Online","group":{"name":"publication_history","label":"Publication History"}}]}}