Research Article Coexisting Iron Deficiency Anemia and Beta Thalassemia Trait: Effect of Iron Therapy on Red Cell Parameters and Hemoglobin Subtypes Sarika Verma, 1 Ruchika Gupta, 2 Madhur Kudesia, 1 Alka Mathur, 3 Gopal Krishan, 4 and Sompal Singh 1 1 Department of Pathology, Hindu Rao Hospital, Malka Ganj, Delhi 110007, India 2 Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India 3 Department of Pediatrics, Hindu Rao Hospital, Malka Ganj, Delhi 110007, India 4 Department of Medicine, Hindu Rao Hospital, Malka Ganj, Delhi 110007, India Correspondence should be addressed to Sompal Singh; sompal151074@gmail.com Received 26 November 2013; Accepted 16 January 2014; Published 12 March 2014 Academic Editors: A. Gatt and H. Knecht Copyright © 2014 Sarika Verma et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Coexistence of iron defciency anemia (IDA) and beta thalassemia trait (BTT) has been the topic of few studies. However, no study from our country was found evaluating the efect of iron therapy in patients with concomitant IDA and BTT. Methods. Over a period of two years, 30 patients with concomitant IDA and BTT were included. All the patients had a complete blood count, serum iron studies, and thalassemia screening using BIORADTM hemoglobin testing system. Te patients received oral iron therapy in appropriate dosages for a period of twenty weeks, afer which all the investigations were repeated. Appropriate statistical methods were applied for comparison of pre- and posttherapy data. Results. All except two patients were adults with a marked female preponderance. Oral iron therapy led to statistically signifcant improvement in hemoglobin, red cell indices ( < 0.05), and marked change in serum iron, ferritin, and HbA 2 levels ( < 0.001). Tere was a signifcant reduction in the total iron binding capacity levels. Conclusion. Te present study shows the frequent occurrence of iron defciency anemia in patients with beta thalassemia trait, which can potentially confound the diagnosis of the latter. Hence, iron defciency should be identifed and rectifed in patients with suspicion of beta thalassemia trait. 1. Introduction Talassemia syndromes and iron defciency anemia (IDA) are the two most common etiologies of microcytic hypochromic anemia in children and adults. It has long been considered that iron defciency does not exist in thalassemia syndromes, including thalassemia major as well as trait. However, studies have shown the occurrence of iron defciency in patients with beta thalassemia trait (BTT). Earlier authors have demonstrated lower initial hemoglobin levels in patients with coexisting IDA and BTT [1–3]. Tis has been explained by the lack of hemopoietic nutrients due to iron defciency superimposing on the imbalance in globin chain synthesis [4]. Similar changes have also been shown in other red cell parameters, serum iron, ferritin, and total iron binding capacity. Tese changes have also been demonstrated to improve afer adequate iron replacement therapy [1, 2, 5]. HbA 2 levels have been reported to be lower in patients with coexisting IDA and BTT, with improvement in levels afer iron therapy [1, 6]. However, other studies have shown no signifcant diference in HbA 2 levels in such patients [7, 8]. Te reduction in HbA 2 levels in patients with concomitant BTT and IDA has been suggested to interfere in the diagnosis of the former. A recent study has hypothesized that such an occurrence can lead to these patients with BTT marrying another person with BTT with attendant risk of birth of thalassemia major child [9]. An extensive search of the available indexed English literature yielded only few Indian reports of concomitant BTT and iron defciency [4, 10–12]. None of these studies Hindawi Publishing Corporation ISRN Hematology Volume 2014, Article ID 293216, 5 pages http://dx.doi.org/10.1155/2014/293216