Why is rdw high in iron deficiency anemia

Meat versus vegetable sources also has an effect on availability. Heme from animal tissues is the most easily absorbed form of iron. As a result, vegetarians are at higher risk of iron deficiency. Decreased gastric pH can also limit iron absorption, which can be a concern in patients receiving aggressive acid blocker for gastrointestinal GI disease such as peptic ulcer disease. Primary bowel disease e. It is unclear if lead toxicity directly impairs absorption or selectively competes with iron, but it is commonly associated with iron deficiency.

GI blood loss is the leading cause of iron deficiency. Occult bleeding can be present for a prolonged period before it is clinically detected.

Urinary blood loss from an underlying renal disorder Berger and Goodpasture syndromes can cause iron deficiency associated with gross versus microscopic hematuria. Pulmonary blood loss leading to iron deficiency is extremely rare and may be associated with pulmonary hemosiderosis. Since there is a gradual progression of anemia, a patient with iron deficiency anemia can be relatively asymptomatic.

General symptoms include pallor, weakness, fatigue, palpitations, and lightheadedness. Rarely patients will have angular stomatitis and glossitis. Patients can also exhibit pica behavior — most classic is eating excessive ice. Studies have shown that iron deficiency with or without anemia leads to impaired growth and intellectual development in children. Some of these cognitive effects are not reversible with iron repletion.

Iron deficiency anemia is often confused with thalassemia trait. Both are associated with anemia and microcytosis. However, red cell distribution width RDW and cell hemoglobin distribution width are normal in thalassemia trait. Iron studies ferritin, serum iron, total iron binding capacity should be normal in a child with thalassemia. The mean corpuscular volume MCV tends to be disproportionately low compared with the hemoglobin level in thalassemia trait very low MCV with mild anemia.

Details of the hemoanalyzer are provided in our previous study [ 18 ]. In summary, the Sysmex KX21N [ 19 ] is an automated blood cell counter intended for in vitro diagnostic use in clinical laboratories. It is a compact, fully automated hematology analyzer with simultaneous analysis of 18 parameters in whole blood mode and capillary blood mode.

This analyzer counts blood cells as routine in a few minutes. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. The current study received ethical approval from the Department of Obstetrics in Khartoum Hospital, Sudan.

During the study period, pregnant women were initially enrolled and fulfilled the inclusion criteria and their data are presented in this report. The characteristics of these women at admission to the study are shown in Table 1. Hemoglobin values ranged from 7. Out of these women, 57 Among the 57 women that had IDA using serum ferritin level as a diagnostic tool, 25 Therefore, the sensitivity of RDW was The specificity of RDW was The positive predictive value of RDW was The negative predictive value of RDW was The main findings of the current study were the low sensitivity Previously, hemoglobin was the most commonly used hematological parameter and screening test for IDA [ 22 ].

However, hemoglobin has its limitation in detecting IDA because sufficient time must elapse for iron to have an effect [ 23 ], and hemoglobin may take up to 2 months to show low levels [ 24 ]. Changes in the peripheral blood film e. Therefore, there is a need for a screening test that is cheap and has a high reliability and accuracy for identifying iron deficiency.

A high sensitivity Different rates of RDW have been reported. For example, Aulakh et al. Some points need to be taken into consideration when comparing different studies. Second, there was a difference in the gestational age between our study and previous studies [ 16 , 28 ]. Therefore, most of the studies, including the current study, were focused and designed to have maximum specificity for diagnosing IDA rather than achieving the most sensitivity.

This study has some limitations. Hemoglobin electrophoresis, serum vitamin B12, and folate tests were not performed. Such tests are important for excluding hemoglobinopathies, early macrocytosis due to folic acid, or vitamin B12 deficiency where RDW may increase.

Anemia of chronic disorders also could not be excluded by an appropriate investigation in cases where serum ferritin levels might have been misinterpreted. The other parameters of iron status or profile such as serum iron level, total iron binding capacity and transferrin saturation were not investigated. Screening for submicroscopic malaria as it is one of the commonest causes of anaemia was not performed.

Google Scholar. BMC Pregnancy Childbirth. The high incidence of iron deficiency anemia in children emphasizes the need for early detection and prompt treatment of this easily treatable condition. An optimal non-invasive method for diagnosing iron deficiency anemia has eluded practitioners for many years. There are various methods to diagnose iron deficiency anemia CBC with RBC indices including RDW, ferritin, Total Iron binding capacity TIBC , and peripheral smear examination but in developing countries these investigations are not always feasible to be done either due to high cost or because of lack of facilities.

The other reason being that the red cell indices are single, mean values and cannot express the variation within the population of cells, hence they are not able to reveal the presence of a small or dual population of abnormal cells. The conventional examination of peripheral blood smear is time consuming and there are both inter-observer and intra-observer variability [12,13]. RDW is a measure of heterogeneity of distribution of red cell size. The generation of RDW curve by the analyst may be useful adjunct in the diagnosis of iron deficiency anemia [14,15].

So, our study was planned to evaluate the significance of red cell distribution width in the diagnosis of iron deficiency anemia. This present study was conducted in the Department of Pediatric, S. Medical College, Jodhpur, India for 12 months. These hundred cases of IDA were evaluated for red cell indices, RDW, serum iron and serum iron binding capacity and transferrin saturation, peripheral blood film examination for red cell morphology. The blood samples were drawn from peripheral vein with the subject in supine position from 9 am — 2 pm as diurnal variation in serum iron levels with highest concentration in the morning and lowest in the evening.

Samples were drawn irrespective of time of feeding as there is no effect of feeding on serum iron levels.

Smears were examined and further confirmed by the senior and expert pathologists who were blind to the findings of clinical examination and reports of serum iron studies. Mean transferrin saturation in mild, moderate and severe anemia was Anemia can be treated with medications, dietary changes, and supplements.

However, untreated anemia can lead to severe complications. In some cases, it can be fatal. Results can indicate the presence of anemia and help to pinpoint the underlying cause.

Microcytic anemia occurs when the body does not get enough oxygen and cannot provide enough energy to all organs and tissues, causing pale skin and…. When blood becomes too thick, it can lead to clots and other complications. Here, learn more about why it happens and the effects. Nutritional-deficiency anemia happens when the body does not get enough iron or a few other nutrients from the diet.

Learn more, including how to…. Mean corpuscular hemoglobin or MCH levels refer to the amount of hemoglobin that is present in a red blood cell. Hemoglobin is a protein that carries…. Iron is a vital mineral in the body, central to transporting oxygen around the body in the hemoglobin.

A shortage of iron can cause health problems…. What does it mean if your RDW is high?