• A three-year review of the medical records of 76 patients with apparent thalassemic syndromes (mean corpuscular volume, <75 cu μm; RBC count, >5 × 106 /cu mm) was performed to assess overall physician response to this information at a midwestern teaching institution. Abnormal indices were recognized in only 50% of the cases; in only 32% of cases was a thalassemic syndrome considered in the differential diagnosis. Residents in internal medicine failed to recognize microcytic indices and to consider thalassemic syndromes 42% and 59% of the time, respectively. Even though hemoglobin electrophoresis was performed in 25 patients, in only 15 (56%) of the 25 cases was β-thalassemia proved or α-thalassemia presumptively diagnosed. In 17% of all cases, the patients were treated with iron without diagnostic findings on iron studies and/or in spite of data suggesting a thalassemic syndrome. The RBC indices are an underused portion of the complete blood cell count, and readily apparent thalassemic syndromes are often not considered.
(Arch Intern Med 1985;145:93-94)
Hansen RM, Hanson G, Anderson T. Failure to Suspect and Diagnose Thalassemic Syndromes: Interpretation of RBC Indices by the Nonhematologist. Arch Intern Med. 1985;145(1):93–94. doi:10.1001/archinte.1985.00360010121019
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