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Red Cell Distribution Width as a Predictive Factor of Celiac Disease in Middle and Late Adulthood and Its Potential
Julia María Cabo Del Riego1,2,3, María Jesús Núñez-Iglesias3,4, José Paz Carreira5
1Clinical Analysis Laboratory, Department of Immunology, Lucus Augusti University Hospital, 27003 Lugo, Spain.
Insights
Red cell distribution width (RDW) shows potential as a screening tool for celiac disorder (CD). Elevated RDW levels were significantly more common in patients with CD, particularly those with severe intestinal atrophy.
Area of Science:
- Gastroenterology
- Hematology
- Immunology
Background:
- Celiac disorder (CD) diagnosis relies on antibody tests and intestinal biopsy.
- Red cell distribution width (RDW) is a measure of red blood cell size variation.
- RDW's utility in celiac disorder assessment requires further investigation.
Purpose of the Study:
- To evaluate the positive case rate of celiac disorder (CD).
- To determine the effectiveness of red cell distribution width (RDW) in diagnosing CD.
- To explore the association between RDW and CD severity.
Main Methods:
- Prospective study of 9,066 adult and elderly patients (2012-2021).
- CD diagnosis via serology, Human Leucocyte Antigen (HLA) genotype, and intestinal biopsy.
- Analysis of gastrointestinal, extra-intestinal, hematological, and biochemical parameters.
Main Results:
- 101 patients (1.11%) were diagnosed with CD, predominantly with Marsh 3a-c atrophy.
- Anemia was the most frequent extra-intestinal manifestation (28.57%).
- High RDW (>14.3%) was observed in 58.40% of CD patients versus 35.2% of non-CD individuals, correlating with CD and grade III atrophy.
Conclusions:
- Red cell distribution width (RDW) may serve as a valuable screening criterion for celiac disorder.
- Elevated RDW is associated with the presence of celiac disorder and severe intestinal damage.
- Further research into RDW's role in early CD detection is warranted.
Abstract:
Red cell distribution width (RDW) could be of interest by its potential use in the assessment of celiac disorder (CD). The main objective of this study was to evaluate the case positive rate of CD and the utility of red cell distribution width (RDW) in the CD diagnosis. This prospective study included 9.066 middle adult (≥45 years old) and elderly patients (≥60 years old) from 2012 to 2021. CD diagnosis was performed by CD antibody tests (serology and Human Leucocyte Antigen genotype (HLA)) and biopsy. Gastrointestinal and extra-intestinal manifestations as well as hematological and biochemical parameters were analyzed. CD diagnoses were confirmed in 101 patients (median (IQR) age = 62 (52.3−73); 68.32% women) by serologic tests (100%) and intestinal biopsy (88.12%), showing mainly marked or complete atrophy (76.24%, MARSH 3a−c). Anemia was the most commonly presenting extra-intestinal manifestation (28.57%). Among 8975 individuals without CD, 168 age and sex matched were included. By comparison of CD and no CD individuals, we observed that high >14.3% RDW was exhibited by 58.40% and 35.2% individuals with CD and without CD, respectively. Furthermore, high RDW is associated with CD and grade III atrophy. We suggest that RDW could be used as a CD screening criterion.
