Iron deficiency anaemia (IDA) often coexists with or superimpose on Beta thalassaemia trait(BTT), causing dilemma in diagnosis and management strategy. Iron deficiency frequently causes a low or normal HbA2 in HPLC chromatogram (5) thereby missing the diagnosis of concomitant BTT.

Correction of iron deficiency  unmasks the  concurrent BTT &  subsequent HPLC reveals a supranormal HbA2, with improvement in anaemia.

Keywords: IDA, BTT, HbA2 level before and after iron therapy.

1. Sarika Verma et al: Coexisting Iron deficiency Anaemia & Beta thalassaemia trait; effect of iron therapy on red cell parameters and haemoglobin subtypes : ISRN.  Hematol : 2014
2. Sheetal Arora et al: Coexistence of iron deficiency & thalassaemia trait : a study in antenatal females : Indian J. Research & Med. Science, Vol-5, No. 12, 2017.
3. El – Agouza et al: The effect of iron deficiency anaemia on the levels of Hemoglobin subtypes: possible consequences for clinical diagnosis.
4. Harthroon l, et al: Influence of iron deficiency anaemia on HbA₂ levels; Scand J. Clin lab invest, 1999, 59 (I) 65 – 70.
5. Gruchy, Clinical Hematology in Medical Practice, 5^th Ed : Oxford University Press.
6. Wallach, Interpretation of diagnostic tests, 7^th Ed, Lippincott.
7. D-10 Hemoglobin testing system: Library of chromatograms : Bio Rad laboratories, USA.

Dr Mani Mohan Bandopadhyay

MBBS, DCP, MIAC

Senior Pathologist, BSM Clinilab Diagnostic and Imaging Centre Pvt Ltd, Dhanbad, Jharkhand. 826001