Title: A Cross sectional study on the Role of Red cell distribution width as a tool to assess the severity of chronic liver disease in a tertiary care hospital

Authors: Dr Anyam Lavanya, Dr B. Ashok Babu, Dr K. Sudheer

 DOI: https://dx.doi.org/10.18535/jmscr/v10i12.18

Abstract

Introduction

Red blood cell distribution width (RDW) is a measurement of the range of RBC volume, size variation and an index of the heterogeneity of circulating RBCs. It is a well-established parameter for identifying the cause of anemia. In the presence of morphologic anisocytosis, RDW (normally 11-24%) increased to 15-18%. In microcytic anemia, it is used to differentiate between iron deficiency and thalassemia in which the former has large RDW and in the later, though the red cells are small are generally uniform in size with a normal small RDW. Large RDW also indicate a dimorphic anemia in case of chronic atrophic gastritis that produce both vitamin B12 malabsorption and deficiency to cause macrocytic anemia and blood loss to cause iron deficiency.1 RDW has been indicated to be an inflammatory indicator for prognosis in a variety of diseases.2,3

Aim of the Study

The aim of the study was to compare the values of RDW in alcoholic and non-alcoholic chronic liver disease and to determine if RDW follows the severity of disease according to Child-Pugh score severity and MELD-Na score.

References

  1. Harrisons principles of internal medicine 21st edition, chapter 62, Interpreting peripheral blood smears, Page 425.
  2. Kai Y, Zishu G, Shihe G, Yufeng G, Qiang Z. Changes in Red Blood Cell Distribution Width is Associated with Liver Function Parameters and Prognosis in Patients with Chronic HBV Liver Disease. Clin Lab. 2016 Nov 1;62(11): 2197-2202. doi: 10.7754/Clin.Lab.2016.160420. PMID: 28164679.
  3. Fan X, Deng H, Wang X, Fu S, Liu Z, Sang J, Zhang X, Li N, Han Q, Liu Z. Association of red blood cell distribution width with severity of hepatitis B virus-related liver diseases. Clin Chim Acta. 2018 Jul;482:155-160. doi: 10.1016/j.cca.2018.04.002. Epub 2018 Apr 6. PMID: 29627486.
  4. Hu Z, Sun Y, Wang Q, Han Z, Huang Y, Liu X, Ding C, Hu C, Qin Q, Deng A. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med. 2013 Jul;51(7):1403-8. doi: 10.1515/cclm-2012-0704. PMID: 23314558 .
  5. Milic S, Mikolasevic I, Radic M, et al. Clinical utility of red cell distribution width in alcoholic and non-alcoholic liver cirrhosis. Coll Antropol 2012; 35 Suppl 2:335–338.

Corresponding Author

Dr Anyam Lavanya

Postgraduate, Department of General Medicine, GEMS