Evaluation of red cell distribution width in the diagnosis of iron deficiency anemia
DOI:
https://doi.org/10.18203/2320-6012.ijrms20162603Keywords:
Red cell distribution width, Iron deficiency anemia, Microcytic hypochromic anemiaAbstract
Background: Iron deficiency anemia is the most common nutritional deficiency world over and in India. It is the most important cause of microcytic hypochromic anemia. Red cell distribution width (RDW) provides quantitative assessment of anisocytosis and could be helpful in differentiating iron deficiency anemia from other microcytic anemias. The objective behind this study was to assess the role of RDW as an early indicator in diagnosing iron deficiency anemia.
Methods: A total of 100 cases of microcytic anemia (MCV <80fl) were included in the study. RDW values were obtained on an automated hematology analyser. Sensitivity, specificity, positive predictive value, negative predictive value of RDW in iron deficiency anemia were studied.
Results: With cut off value of 14.5%, sensitivity and specificity of RDW as a test in diagnosis of iron deficiency anemia were 84.81% and 57.14% respectively and a positive and negative predictive value of 88.15% and 50% respectively.
Conclusions: RDW has a high sensitivity and can be used as a simple, economical, reliable automated red blood cell parameter for initial diagnosis of iron deficiency anemia.
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References
Saroja CN, Alapaty S, Jeyan M. Efficacy of red cell distribution width (RDW) as a screening test for diagnosing children with iron deficiency anaemia. Sch J App Med Sci. 2014;2(6):3412-5.
Chaudhary M, Sharma D, Shekhawat DS, Dabi D. Significance of red cell distribution width in the diagnosis of iron deficiency anemia: an observational study from India. J Pediatr Neonatal Care.2015;2(6):00102.
Jadhav MN, Agarwal SA, Kadgi NV, Khedkar SS. Utility of automated RBC parameters in evaluation of anemia. Int J Healthcare Biomed Res. 2015;3(3):170-181.
Nesa A, Tayab A, Sultana T, Khondker L, Rahman Q, Karim A, et al. RDWI is better discriminant than RDW in differentiation of iron deficiency anemia and beta thalassaemia trait. Bangladesh J Child Health. 2009;33(3):100-3.
Van ZD, Bieger R, Van WRKA, Castel A, Hermans J. Evalution of microcytosis using serum ferritin and red blood cell distribution width. Eur J Haematol. 1990;44:105-8.
Aulakh R, Sohi I, Singh T, Kakkar N. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia. Indian J Pediatr. 2009;76(3):265-7.
Nadeem R, Ahmed N, Qureshi GR. Automated measurement of red blood cell microcytosis and hypochromia in iron deficiency and beta thalassemia trait. Pak J Med Health Sci. 2012;6(1):20-3.
Red blood cell and bleeding disorders. In: Kumar V, Abbas AK, Aster JC, editors. Robbins and Cotran Pathologic Basis of Disease. 9th ed. New Delhi: Elsevier: 2014;629-667.
Khatri A, Kavatkar A, Puranik S. Evaluation of red cell distribution width (RDW) and other indices in microcytic anemias. Medical J Western India. 2013;41(1):76-80.
Santosh S, Kushal KK, Ramesh AC. A study on red cell distribution width in relation to other iron (red cell) indices with special reference to reticulocyte count before and after oral iron therapy in iron deficiency anemia. Int J Basic Applied Med Sci. 2013;3(1):292-9.
Perkins SL. Examination of blood and bone marrow. In: Greer JP et al, editors. Wintrobe’s clinical hematology. 12th ed. Philadelphia: Lippincott Williams and Wilkins:2009;1-20.
Lewis SM. Reference ranges and normal values. In: Lewis SM, Bain BJ, Bates I, editors. Dacie and Lewis Practical Haematology. 9th ed. London:Churchill Livingstone:2001;9-18.
Pandya AN, Agarwal M, Dave D. Red cell distribution width as a screening tool in classifying microcytic hypochromic anemias. J Evolution Med Dent Sci. 2014;3(23):6559-65.
Qureshi NA, Chauhan MAZ, Goswami AP, Suri SK. Study of anemia and its correlation with hematological parameters in patients of various age group. J Dental Med Sci. 2015;14(9):29-35.
Nadeem R, Ahmed N, Bashir S. Frequency of iron deficiency anaemia and beta thalassaemia trait at haematology department of children hospital, Lahore. Biomedica. 2012;28:66-70.
Batebi A, Pourreza A, Esmailian R. Discrimination of beta-thalassemia minor and iron deficiency anemia by screening test for red cell indices. Turk J Med Sci. 2012;42(2):275-80.
Wharton BA. Iron deficiency in children: detection and prevention. British J Haematology. 1999;106:270-80.
Flynn MM, Reppun TS, Bhagavan NV. Limitations of red cell distribution width (RDW) in evaluation of microcytosis. Am J Clin Pathol. 1986;85(4):445-9.
Sirachainam N, Iamsirirak, Pimlak, Charoenkwan P, Kadegasem P, Wongwerawattnakoon P, et al. New mathematical formula for differentiating thalassemia trait and iron deficiency anemia in thalassemia prevalent area: a study in healthy school-age children. Southeast Asian J Trop Med Public Health. 2014;45(1):174-82.
Aslan D, Gumruk F, Gurgey A, Altay C. Importance of RDW value in differential diagnosis of hypochrome anemias. Am J Hematology. 2002;69:31-3.
Approach to diagnosis of anemias. In: Kawthalkar SM, editor. Essentials of haematology. 2nd ed. New Delhi: Jaypee Brothers:2013;52-70.