Clinico-hematological profile of hemoglobin e disorders in a peripheral tertiary care centre of north bengal: A cross-sectional study emphasizing rbc indices

Background: Hemoglobin E (HbE) disorders are prevalent in eastern and northeastern India, including North Bengal.However, detailed clinico-hematological data from peripheral tertiary care centres remain limited. Red blood cell (RBC)indices may provide useful supportive information for screening and identifying individuals requiring confirmatory testing.Objective: To evaluate the clinico-hematological profile of HbE disorders in a peripheral tertiary care centre of NorthBengal, with particular emphasis on RBC indices. Materials and Methods: This hospital-based cross-sectionalobservational study was conducted in the Department of Pathology and Thalassemia Control Unit of Jalpaiguri GovernmentMedical College and Hospital during 2024–2025. Subjects diagnosed with HbE disorders by cation-exchange highperformanceliquid chromatography (CE-HPLC) or hemoglobin electrophoresis were evaluated. Demographic and clinicaldetails and hematological parameters, including hemoglobin, RBC count, MCV, MCH, MCHC, RDW and HbF, wereassessed. A total of 3,264 subjects were included, comprising 1,069 HbE disease cases and 2,195 HbE carriers.Results: Themajority of subjects belonged to the 21–40-year age group (65.9% of HbE disease cases and 67.6% of carriers), with femalepredominance in both groups (77.6% and 83.4%, respectively). Approximately half were asymptomatic. Low hemoglobinwas observed in 94.8% of disease cases and 83.7% of carriers. Microcytosis was prominent, with reduced MCV in 98.0%and 81.5%, respectively. Low MCH was observed in 91.7% of disease cases and 91.8% of carriers, while RDW was elevatedin 84.7% and 71.2%, respectively. HbF remained normal in all subjects.Conclusion:HbE disorders commonly demonstratedmicrocytic hypochromic hematological abnormalities, more pronounced in HbE disease than in carriers. RBC indices,particularly MCV, MCH and RDW, are useful supportive screening parameters, but definitive diagnosis requires CE-HPLCbasedhemoglobin analysis. Early detection and genetic counseling are important for prevention of severe HbE-relatedhemoglobinopathies.