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Anemia and red cell distribution width at the 12-month well-baby examination
1Department of Medicine, Womack Army Medical Center, Fort Bragg, NC 28307-5000, USA.
Insights
The red cell distribution width (RDW) effectively identifies anemia causes in healthy 12-month-olds. This screening tool helps detect conditions like iron deficiency and thalassemia early.
Area of Science:
- Pediatric Hematology
- Clinical Diagnostics
Background:
- Anemia screening is common in children.
- Red cell distribution width (RDW) is a potential diagnostic aid for pediatric anemias.
- Prospective studies on RDW use in pediatric anemia screening are lacking.
Purpose of the Study:
- To prospectively evaluate the utility of RDW in identifying causes of anemia in 12-month-old infants.
- To determine if RDW can serve as a screening tool for pediatric anemias.
Main Methods:
- A screening hematocrit was performed on 970 infants at their 12-month well-baby visit.
- Low hematocrit values were confirmed by complete blood count (CBC).
- Infants with low hematocrit underwent iron therapy, followed by hemoglobin electrophoresis if necessary.
Main Results:
- Of 11 infants with abnormal RDW, 9 had identifiable anemia causes (iron deficiency, alpha-thalassemia, hemoglobin SC/AS).
- Infants with normal RDW showed no such abnormalities.
- RDW demonstrated a significant correlation with diagnosed anemia types.
Conclusions:
- The RDW alone is a predictive indicator for identifiable causes of anemia in healthy 12-month-old infants.
- RDW can be a valuable tool in routine pediatric anemia screening.
- Further research can explore RDW's role in diverse pediatric populations.
Background:
Screens for anemia are among the most commonly done laboratory tests in children. The red cell distribution width (RDW) has been proposed as a diagnostic aid in the evaluation of pediatric anemias, but no prospective studies have been published describing its use.
Methods:
A screening hematocrit determination done at the 12-month well-baby examination in 970 healthy infants yielded 62 low values (< 33%), 31 of which were confirmed by heel stick complete blood count (CBC). After a 1-month trial of iron therapy, those with a rise in hemoglobin of at least 1 g/dL were considered to have iron-deficiency anemia. Nonresponders, after review of clinical and laboratory data (CBC, lead screen, and sickle screen), had hemoglobin electrophoresis if indicated.
Results:
Abnormalities detected were iron deficiency, alpha-thalassemia, and hemoglobins SC and AS. These conditions were detected in 9 of 11 infants with abnormal RDW and none of 9 with normal RDW.
Conclusions:
The RDW alone appears to be predictive of identifiable causes of anemia when used in screening 12-month-old babies who are otherwise healthy.