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Related Experiment Videos

Evaluation of red cell volume distribution width (RDW).

W L Marsh1, J W Bishop, T P Darcy

  • 1Department of Laboratory Medicine, Naval Hospital, San Diego, California.

Hematologic Pathology
|January 1, 1987
PubMed
Summary

Red cell distribution width (RDW) shows promise in diagnosing anemias, but it is not specific enough to replace standard laboratory methods for differentiating iron deficiency from thalassemia trait.

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Area of Science:

  • Hematology
  • Clinical Diagnostics

Background:

  • Differential diagnosis of anemia is crucial for effective treatment.
  • Iron deficiency (ID), anemia of chronic disease (ACD), and thalassemia trait are common causes of anemia with overlapping features.
  • Red cell distribution width (RDW) is a parameter reflecting red blood cell size variability.

Purpose of the Study:

  • To evaluate the utility of RDW in differentiating between ID, ACD, and thalassemia trait.
  • To assess the effectiveness of the Bessman classification using RDW and mean corpuscular volume (MCV).

Main Methods:

  • Analysis of RDW values in patient cohorts with confirmed diagnoses of ID, ACD, beta-thalassemia trait, alpha-thalassemia trait, sickle cell trait, and sickling disorders.
  • Comparison of RDW with MCV for diagnostic classification.

Main Results:

  • Elevated RDW (>15.0%) was observed in 90% of ID, 66% of beta-thalassemia trait, and 53-66% of alpha-thalassemia trait cases.
  • RDW was elevated in 32% of ACD and only 3% of sickle cell trait.
  • The Bessman classification showed limited value in separating ID from thalassemia trait, but improved with an RDW upper limit of 16.0%.

Conclusions:

  • RDW can be a useful indicator in the differential diagnosis of anemia, particularly in identifying potential ID or thalassemia trait.
  • RDW alone is not sufficiently specific or sensitive to definitively distinguish between ID and thalassemia trait.
  • Standard laboratory methods remain essential for confirming diagnoses of anemia subtypes.

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