{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T18:25:27Z","timestamp":1776450327000,"version":"3.51.2"},"reference-count":15,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1994,3]]},"abstract":"<jats:p>AIMS--To determine the value of the red cell distribution width (RDW) and erythrocyte zinc protoporphyrin (ZPP) concentration in discriminating between iron deficiency, and beta and alpha thalassaemia in a mixed urban Asian population. METHODS--The RDW and ZPP concentrations were measured in 1412 subjects attending for outpatient phlebotomy, with classification into diagnostic groups on the basis of haemoglobin, mean cell haemoglobin, ferritin, HbA2 and haemoglobin electrophoresis. RESULTS--Non-parametric 95% reference ranges for RDW were 11.7-15.7% and for ZPP 38-104 mumol\/mol haem. Both RDW and zinc protoporphyrin rose with increasing severity of iron deficiency, but were also raised in significant numbers of subjects with beta and probable alpha thalassaemia. CONCLUSIONS--Measurements of RDW and ZPP do not differentiate between alpha or beta thalassaemia trait and moderate degrees of iron deficiency (hypochromasia without anaemia). ZPP is a more accurate indicator of iron deficiency than RDW and concentrations above 150 mumol\/mol haem strongly suggest iron deficiency, usually with anaemia, rather than thalassaemia.<\/jats:p>","DOI":"10.1136\/jcp.47.3.205","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"205-208","source":"Crossref","is-referenced-by-count":22,"title":["Zinc protoporphyrin assays in patients with alpha and beta thalassaemia trait."],"prefix":"10.1136","volume":"47","author":[{"given":"M L","family":"Tillyer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C R","family":"Tillyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1093\/ajcp\/80.3.322","article-title":"Improved classification of anemias by MCV and RDW","volume":"80","author":"Bessman, J.D.; Gilmer, P.R.; Gardner, F.H.","year":"1983","unstructured":"Bessman JD, Gilmer PR, Gardner FH. Improved classification of anemias by MCV and RDW. Am J Clin Pathol 1983;80:322-6.","journal-title":"Am J Clin Pathol"},{"key":"ref_2","first-page":"1231","article-title":"Lead poisoning and thalassaemia trait or iron deficiency. The value of the red cell distribution width","volume":"144","author":"Bhambhani, K.; Aronow, R.","year":"1990","unstructured":"Bhambhani K, Aronow R. Lead poisoning and thalassaemia trait or iron deficiency. The value of the red cell distribution width. AmJDis Child 1990;144:1231-3.","journal-title":"AmJDis Child"},{"key":"ref_3","first-page":"259","article-title":"Combined use of zinc protoporphyrin (ZPP), mean corpuscular volume and haemoglobin measurements for classifying microcytic RBC disorders","volume-title":"children and young adults. Clin Lab Haematol 1985","volume":"7","author":"Hershko, C.; Konijn, A.M.; Link, G.; Moreb, J.; Grauer, F.; Weissenberg, E.","unstructured":"Hershko C, Konijn AM, Link G, Moreb J, Grauer F, Weissenberg E. Combined use of zinc protoporphyrin (ZPP), mean corpuscular volume and haemoglobin measurements for classifying microcytic RBC disorders in children and young adults. Clin Lab Haematol 1985;7:259-69."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1093\/ajcp\/79.6.661","article-title":"Free erythrocyte protoporphyrin (FEP) II. The FEP test is clinically useful in classifying microcytic disorders in adults","volume":"79","author":"Marsh, W.L.; Nelson, D.P.; Koenig, H.M.","year":"1983","unstructured":"Marsh WL, Nelson DP, Koenig HM. Free erythrocyte protoporphyrin (FEP) II. The FEP test is clinically useful in classifying microcytic disorders in adults. Am Jf Clin Pathol 1983;79:661-6.","journal-title":"Am Jf Clin Pathol"},{"key":"ref_5","first-page":"157","article-title":"Thalassaemia, abnormal haemoglobins and iron deficiency in a British Asian population","volume":"15","author":"Tillyer, M.L.; Varawalla, N.Y.; Tillyer, C.R.; Sandhu, P.; Modell, B.","year":"1993","unstructured":"Tillyer ML, Varawalla NY, Tillyer CR, Sandhu P, Modell B. Thalassaemia, abnormal haemoglobins and iron deficiency in a British Asian population. Clin Lab Haematol 1993;15:157-64.","journal-title":"Clin Lab Haematol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1365-2141.1976.tb00190.x","article-title":"Alpha-thalassaemia trait in various racial groups in the United Kingdom: characterization of a variant of alpha-thalassaemia in Indians","volume":"34","author":"Walford, D.M.; Deacon, R.","year":"1976","unstructured":"Walford DM, Deacon R. Alpha-thalassaemia trait in various racial groups in the United Kingdom: characterization of a variant of alpha-thalassaemia in Indians. BrJ Haematol 1976;34: 193-206.","journal-title":"BrJ Haematol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1182\/blood.V71.2.467.467","article-title":"The molecular basis of a-thalassaemia in India. Its interaction with the sickle cell gene","volume":"71","author":"Kulozik, A.E.; Kar, B.C.; Serjeant, G.R.; Serjeant, B.E.; Weatherall, D.J.","year":"1988","unstructured":"Kulozik AE, Kar BC, Serjeant GR, Serjeant BE, Weatherall DJ. The molecular basis of a-thalassaemia in India. Its interaction with the sickle cell gene. Blood 1988;71:467-72.","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/clinchem\/39.4.561","article-title":"Receiver-Operating characteristic (ROC) plots: a fundamental evaluation tool in","volume":"39","author":"Zweig, M.H.; Campbell, G.","year":"1993","unstructured":"Zweig MH, Campbell G. Receiver-Operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 1993;39:561-77.","journal-title":"clinical medicine. Clin Chem"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/S0140-6736(73)91878-3","article-title":"Differentiation of iron deficiency from thalassaemia trait by routine blood count","volume":"i:","author":"England, J.M.; Fraser, P.M.","year":"1973","unstructured":"England JM, Fraser PM. Differentiation of iron deficiency from thalassaemia trait by routine blood count. Lancet 1973;i:449-52.","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S0140-6736(73)91446-3","article-title":"Differentiation of iron deficiency from thalassaemia trait","volume":"i:","author":"Mentzer, W.C.","year":"1973","unstructured":"Mentzer WC. Differentiation of iron deficiency from thalassaemia trait. Lancet 1973;i:882.","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S0140-6736(79)90733-5","article-title":"Discrimination between iron deficiency and heterozygous thalassaemia","volume":"i:","author":"Walford, D.M.; McPherson, K.; Deacon, R.","year":"1979","unstructured":"Walford DM, McPherson K, Deacon R. Discrimination between iron deficiency and heterozygous thalassaemia. Lancet 1979;i:323.","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1093\/ajcp\/85.4.445","article-title":"Limitations of red cell distribution width (RDW) in evaluation of microcytosis","volume":"85","author":"Flynn, M.M.; Reppun, T.S.; Bhagavan, N.V.","year":"1986","unstructured":"Flynn MM, Reppun TS, Bhagavan NV. Limitations of red cell distribution width (RDW) in evaluation of microcytosis. Am J Clin Pathol 1986;85:445-9.","journal-title":"Am J Clin Pathol"},{"key":"ref_13","first-page":"40","article-title":"Zinc protoporphyrin: a product of iron-deficient erythropoiesis","volume":"36","author":"Labbe, R.F.; Rettmer, R.L.","year":"1989","unstructured":"Labbe RF, Rettmer RL. Zinc protoporphyrin: a product of iron-deficient erythropoiesis. Semin Hematol 1989;36: 40-6.","journal-title":"Semin Hematol"},{"key":"ref_14","first-page":"33","article-title":"Red cell distribution width, free erythrocyte protoporphyrin, and England-Fraser Index in the differential diagnosis of microcytosis due to iron deficiency or beta-thalassaemia trait. A study","volume":"5","author":"Junca, J.; Flores, A.; Roy, C.; Alberti, R.; Milla, F.","year":"1991","unstructured":"Junca J, Flores A, Roy C, Alberti R, Milla F. Red cell distribution width, free erythrocyte protoporphyrin, and England-Fraser Index in the differential diagnosis of microcytosis due to iron deficiency or beta-thalassaemia trait. A study of 200 cases of microcytic anemia. Hematol Pathol 1991;5:33-66.","journal-title":"Hematol Pathol; cases of microcytic anemia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/ijlh.1990.12.2.169","article-title":"a-Thalassaemia and fl-thalassaemia traits: biological difference based on red cell indices and zinc protoporphyrin","volume":"12","author":"Han, P.; Kung, K.P.; Teo, C.P.; Tam, L.P.","year":"1990","unstructured":"Han P, Kung KP, Teo CP, Tam LP. a-Thalassaemia and fl-thalassaemia traits: biological difference based on red cell indices and zinc protoporphyrin. Clin Lab Haematol 1990;12: 169-76.","journal-title":"Clin Lab Haematol"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.47.3.205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T05:51:30Z","timestamp":1765691490000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.47.3.205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,3]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1994,3,1]]},"published-print":{"date-parts":[[1994,3]]}},"alternative-id":["10.1136\/jcp.47.3.205"],"URL":"https:\/\/doi.org\/10.1136\/jcp.47.3.205","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,3]]}}}