Validity of Shine and Lal Index {MCV2XMCHX0.01} in Predicting Iron Deficiency Anemia

Abstract

Objective: To determine the diagnostic accuracy of the Shine and Lal index in detecting the presence of iron deficiency anaemia, keeping serum ferritin levels and serum transferrin saturation as the gold standard.

Study Design: Cross-sectional validation study.

Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi Pakistan, Nov 2021 to
May 2022.

Methodology: We studied a total of 113 patients who presented with microcytic anaemia were included for study. Patients
diagnosed as cases of thalassemia, haemolytic anaemia, iron deficiency anaemia, had received blood transfusions within the
past three months, or were receiving iron therapy within the six months were excluded. The diagnosis of iron deficiency was
based on a serum ferritin level of less than 14 ng/mL and/or a transferrin saturation of less than 20%. A Shine and Lal index
greater than 1530 was considered diagnostic for iron deficiency anaemia.

Results: The mean age of our sample was 6.64±2.89 years, 52.2% of whom were male. The Shine and Lal index carried a sensitivity of 34.8%, a specificity of 74.6% and a diagnostic accuracy of 58.4% in predicting the presence of iron deficiency anaemia,vusing a cut-off level greater than 1530. A total of 9.7% of patients tested positive for β-thalassemia trait.

Conclusion: The Shine and Lal index can be employed as a useful, rapid screening test performed on indices readily available as a standard part of complete blood counts but should not be used in isolation.