title: Red cell distribution width can predict intestinal atrophy in selected patients with celiac disease.
abstract: BACKGROUND
  Red cell distribution width (RDW) has been shown as a distinctive marker of mortality and morbidity in a wide spectrum of conditions related to systemic inflammation or deficiency of antioxidant nutrients.
  
  
  OBJECTIVE
  We aimed to investigate the predictive value of RDW in detection of intestinal atrophy in celiac disease (CD).
  
  
  METHODS
  Iron indices and RDW were studied in 49 patients with CD to evaluate the utilization of RDW as a predictive marker for presence of intestinal atrophy.
  
  
  RESULTS
  Sixty-nine percent of patients had iron deficiency at initial presentation and 89% had abnormal RDW defined as >14. Receiver operating characteristics curves of RDW has been found to be a predictive of intestinal atrophy at levels higher than 17.25 (68% sensitivity and 85% specificity). In patients with transglutaminase antibody IgA titers >200 U/l, RDW level >17.75 showed 76% sensitivity and 100% specificity for intestinal atrophy.
  
  
  CONCLUSIONS
  We suggest that RDW can be used as a surrogate marker of atrophy in patients with iron deficiency and suspected CD. In addition, the sensitivity, specificity, negative and positive predictive values of RDW increases when used in combination with high levels of transglutaminase IgA antibody.
authors.affiliation: Department of Gastroenterology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey. ozgurmd@hacettepe.edu.tr
authors.forename: Ozgur
authors.initials: O
authors.lastname: Harmanci
authors.forename: Taylan
authors.initials: T
authors.lastname: Kav
authors.forename: Bulent
authors.initials: B
authors.lastname: Sivri
mesh_terms: D000293:Adolescent; D000328:Adult; D001284:Atrophy / Q000175:diagnosis / Q000503:physiopathology; D002446:Celiac Disease / Q000097:blood*; D016009:Chi-Square Distribution; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology* / Q000503:physiopathology; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014168:Transferrin / Q000378:metabolism
chemical_list: D014168:Transferrin; D007501:Iron