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Red cell distribution width in the diagnosis of iron deficiency anemia
D Viswanath1, R Hegde, V Murthy
1Department of Pediatrics, M.S. Ramaiah Medical Teaching Hospital, Bangalore, India.
Insights
Red cell distribution width (RDW) is more sensitive than peripheral smear (PS) for diagnosing mild to moderate iron deficiency anemia (IDA) in children. Both RDW and PS indicators improved significantly after iron therapy.
Area of Science:
- Pediatrics
- Hematology
- Diagnostic Medicine
Background:
- Iron deficiency anemia (IDA) is a prevalent nutritional deficiency in children globally.
- Accurate and early diagnosis of IDA is crucial for timely intervention and preventing long-term complications.
- Peripheral smear (PS) and Red cell distribution width (RDW) are common hematological parameters used in anemia diagnosis.
Purpose of the Study:
- To compare the diagnostic sensitivity of peripheral smear (PS) and Red cell distribution width (RDW) for various grades of iron deficiency anemia (IDA) in children.
- To evaluate the changes in RDW and PS following iron therapy in pediatric patients with IDA.
Main Methods:
- A cohort of 100 children aged six months to five years with microcytic anemia (Hemoglobin <11 g%, MCV<80fl) were assessed.
- Exclusion criteria included prior blood transfusion or iron therapy.
- Evaluations involved clinical examination, complete blood count (CBC), RDW, peripheral smear microscopy, serum iron, and transferrin saturation. IDA patients received 8 weeks of oral iron, with follow-up assessments.
Main Results:
- Out of 100 children, 89 were diagnosed with IDA (48% mild, 42% moderate, 10% severe).
- Peripheral smear showed microcytosis and hypochromia in 100% of severe IDA cases, 61.5% of moderate, and 22.5% of mild IDA.
- RDW indicated iron deficiency in 100% of mild and severe IDA cases, and 82.05% of moderate IDA cases.
Conclusions:
- RDW demonstrated higher sensitivity than peripheral smear (PS) in diagnosing mild and moderate iron deficiency anemia (IDA).
- Significant improvements in red cell morphology, hemoglobin (Hb), packed cell volume (PCV), and RDW were observed after iron therapy.
Objective:
1. To compare peripheral smear (PS) and Red cell distribution width (RDW) in diagnosis of Iron deficiency anemia (IDA) in various grades. 2. To study the changes in RDW and PS after therapy.
Methods:
Children in the age group of six months to five years with microcytic (MCV<80fl) anemia (Hemoglobin <11 g%) were evaluated. Those who had received blood transfusion and /or were already on iron therapy were excluded. Evaluation included clinical examination, complete blood count (CBC), RDW estimation microscopic examination of peripheral smear, measurement of serum iron and transferrin saturation. Children with IDA were treated with oral iron for 8 weeks and PS, CBC including RDW were repeated.
Result:
Of the 100 children evaluated, 89 had IDA. 48% had mild, 42% had moderate and 10% had severe anemia. Transferrin saturation correlated with severity of anemia. Peripheral smear showed microcytosis and hypochromia in all cases with severe anemia, 61.5% and 22.5% of those with moderate and mild anemia respectively. RDW was suggestive of iron deficiency in 100%, 82.05% and 100% of patient with mild, moderate and severe anemia respectively.
Conclusion:
In the diagnosis of mild and moderate iron deficiency anemia, RDW had a higher sensitivity than PS. Red cell morphology, Hb, PCV and RDW showed significant improvement after iron-therapy.