Decreased hemoglobinization of red cells resulting in hypochromia and microcytosis are the main features of
thalassemia syndromes, and also of iron deficiency anemia (IDA). A simple and reliable method is required to
distinguish the two conditions in the routine laboratories. In this study we analyzed the red cell and reticulocyte
parameters from414 samples of various types of thalassemias and IDA and discovered a variety of discriminating
criteria including a discrimination index (DI) which should be useful for differential diagnosis.
Slightly decreased MCV and CH are suggestive of α-thalassemia 2, Hb CS, and Hb E heterozygotes whereas the
increased Rbc counts are obvious in α-thalassemia 1 and β-thalassemia. In Hb E, the number of microcytic red
cells was greater than the number of hypochromic red cells resulting in an increased M/H ratio. Hb H diseases
are characterized by a higher number of hypochromic red cells and decreased CHCM,while broadening of hemoglobin
concentration histogram results in increased HDW in β-thalassemia diseases. Iron deficiency anemia
results in hypochromic–microcytic red cells and increased RDW. The number of reticulocyte with %High Retic
and CHr value were increased in the firstmonth of iron supplementation indicating the response to iron therapy