Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia.
OBJECTIVE
To study the utility of red cell distribution width (RDW) in the diagnosis of iron deficiency among children with microcytic hypochromic anemia.


METHODS
151 children (6 months-12 years) with microcytic (MCV<75 fl) anemia were classified into iron deficient (IDA) and non-iron deficient anemia (non-IDA) on the basis of serum ferritin and total iron binding capacity (TIBC). RDW values were obtained on an automated hematology analyzer. Receiver operator curves (ROC) were constructed and the utility of RDW in diagnosis of iron deficiency was studied.


RESULTS
The mean RDW value was 18.37+/-2.22% in IDA group (97 children) compared to 16.55+/-1.51 % in the non-IDA group (54 children) (p<0.0001, unpaired t test). In IDA group, the mean RDW value was 16.60+/-1.78%, 17.95+/-1.91% and 20.55+/-1.32% among mild, moderate and severely anemic children (p<0.0001, ANOVA test). The corresponding values in non-IDA group were 16.03+/-1.25%, 16.76+/-1.20% and 16.77+/-2.68% respectively (p=0.269, ANOVA test). At a cut-off value of 17.4%, as obtained from the ROC curve, the sensitivity and specificity of RDW in diagnosis of IDA were 81.0% and 53.4% and a positive and negative predictive value of 63.0% and 72.2% respectively.


CONCLUSIONS
RDW has a limited specificity for diagnosis of IDA among children with microcytic hypochromic anemia.
Aulakh
Roosy
R
Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, Punjab, India.
Sohi
Inderpreet
I
Singh
Tejinder
T
Kakkar
Naveen
N
D000704:Analysis of Variance; D000747:Anemia, Hypochromic / Q000097:blood* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D004909:Erythrocyte Indices; D004911:Erythrocyte Volume; D004913:Erythrocytes, Abnormal / Q000473:pathology / Q000502:physiology*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007194:India; D007223:Infant; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D005293:Ferritins; D007501:Iron