Anemia and red cell distribution width at the 12-month well-baby examination.
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.
Choi
Y S
YS
Department of Medicine, Womack Army Medical Center, Fort Bragg, NC 28307-5000, USA.
Reid
T
T
D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000188:drug therapy; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D006293:Health Promotion; D006400:Hematocrit; D006801:Humans; D007223:Infant; D007501:Iron / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017085:alpha-Thalassemia / Q000175:diagnosis*
D007501:Iron