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Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia
Roosy Aulakh1, Inderpreet Sohi, Tejinder Singh
1Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, Punjab, India.
Insights
Red cell distribution width (RDW) shows limited specificity in diagnosing iron deficiency anemia (IDA) in children with microcytic hypochromic anemia. While RDW is elevated in IDA, its diagnostic accuracy is constrained, necessitating further investigation for reliable diagnosis.
Area of Science:
- Pediatric Hematology
- Diagnostic Biomarkers
- Anemia Research
Background:
- Microcytic hypochromic anemia is common in children.
- Iron deficiency anemia (IDA) is a primary cause, but differentiation can be challenging.
- Red cell distribution width (RDW) is a readily available hematological parameter.
Purpose of the Study:
- To evaluate the diagnostic utility of RDW in identifying iron deficiency among pediatric patients with microcytic hypochromic anemia.
- To determine the sensitivity and specificity of RDW for IDA diagnosis in this population.
Main Methods:
- A study involving 151 children (6 months-12 years) with microcytic anemia (MCV<75 fl).
- Classification into iron deficient anemia (IDA) and non-IDA groups based on serum ferritin and total iron binding capacity (TIBC).
- RDW values analyzed using automated hematology analyzers and receiver operator curves (ROC).
Main Results:
- Mean RDW was significantly higher in the IDA group (18.37+/-2.22%) compared to the non-IDA group (16.55+/-1.51%) (p<0.0001).
- RDW values increased with anemia severity in the IDA group (p<0.0001).
- At a cut-off of 17.4%, RDW showed 81.0% sensitivity and 53.4% specificity for IDA diagnosis.
Conclusions:
- RDW demonstrates a high sensitivity but limited specificity for diagnosing IDA in children with microcytic hypochromic anemia.
- The findings suggest RDW alone is insufficient for definitive IDA diagnosis in this context.
- Further diagnostic markers or strategies may be required for accurate identification of iron deficiency.
Objective:
To study the utility of red cell distribution width (RDW) in the diagnosis of iron deficiency among children with microcytic hypochromic anemia.
Methods:
151 children (6 months-12 years) with microcytic (MCV<75 fl) anemia were classified into iron deficient (IDA) and non-iron deficient anemia (non-IDA) on the basis of serum ferritin and total iron binding capacity (TIBC). RDW values were obtained on an automated hematology analyzer. Receiver operator curves (ROC) were constructed and the utility of RDW in diagnosis of iron deficiency was studied.
Results:
The mean RDW value was 18.37+/-2.22% in IDA group (97 children) compared to 16.55+/-1.51 % in the non-IDA group (54 children) (p<0.0001, unpaired t test). In IDA group, the mean RDW value was 16.60+/-1.78%, 17.95+/-1.91% and 20.55+/-1.32% among mild, moderate and severely anemic children (p<0.0001, ANOVA test). The corresponding values in non-IDA group were 16.03+/-1.25%, 16.76+/-1.20% and 16.77+/-2.68% respectively (p=0.269, ANOVA test). At a cut-off value of 17.4%, as obtained from the ROC curve, the sensitivity and specificity of RDW in diagnosis of IDA were 81.0% and 53.4% and a positive and negative predictive value of 63.0% and 72.2% respectively.
Conclusion:
RDW has a limited specificity for diagnosis of IDA among children with microcytic hypochromic anemia.
