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Red blood cell distribution width in untreated pernicious anemia
S Saxena1, J M Weiner, R Carmel
1Interpretive Clinical Pathology Unit, LAC/USC Medical Center 90033.
American Journal of Clinical Pathology
|May 1, 1988
Summary
Red blood cell distribution width (RDW) is often high in pernicious anemia, but many patients have normal RDWs. This finding suggests RDW may not be the earliest indicator of vitamin B12 deficiency.
Area of Science:
- Hematology
- Internal Medicine
- Nutritional Science
Background:
- Pernicious anemia is a condition caused by vitamin B12 deficiency.
- Red blood cell distribution width (RDW) is a measure of red blood cell size variation.
- High RDW is often considered a sensitive indicator of vitamin B12 deficiency.
Purpose of the Study:
- To investigate the prevalence of normal RDW in untreated pernicious anemia patients.
- To assess the utility of RDW as an early diagnostic marker for vitamin B12 deficiency.
Main Methods:
- Studied RDW in 26 patients with untreated pernicious anemia.
- Sequentially monitored RDW changes after therapy in 12 patients.
- Compared RDW values with controls and mean corpuscular volume (MCV).
Main Results:
- Mean RDW was significantly higher in pernicious anemia patients (21.7%) than controls (13.2%).
- 31% of patients had normal RDWs, with no consistent pattern related to deficiency stage.
- 35% of patients had normal MCV, and over half of those with normal RDW also had normal MCV.
Conclusions:
- A significant proportion of untreated pernicious anemia patients exhibit normal RDW values.
- Elevated RDW is not consistently the earliest sign of vitamin B12 deficiency, unlike in iron deficiency.
- RDW's diagnostic value in early pernicious anemia may be limited.