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Li J, Gao W, Liu J, Zhang X, Tao J, Zhang G. Red blood cell distribution width and maximum left ventricular wall thickness predict poor outcomes in patients with hypertrophic cardiomyopathy. Echocardiography 2022; 39:278-285. [PMID: 35066909 DOI: 10.1111/echo.15303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/05/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jia Li
- Department of Cardiology The Jiangmen Central Hospital The Jiangmen Central Hospital of Sun Yat‐Set University Jiangmen China
- Department of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou China
- Grade 17, Sun Yat‐sen University Zhongshan School of Medicine Sun Yat‐sen University Guangzhou China
| | - Weidong Gao
- Department of Cardiology The Jiangmen Central Hospital The Jiangmen Central Hospital of Sun Yat‐Set University Jiangmen China
| | - Jinxue Liu
- Department of Cardiology The Jiangmen Central Hospital The Jiangmen Central Hospital of Sun Yat‐Set University Jiangmen China
| | - Xuefang Zhang
- Department of Cardiology The Jiangmen Central Hospital The Jiangmen Central Hospital of Sun Yat‐Set University Jiangmen China
| | - Jun Tao
- Department of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Gaoxing Zhang
- Department of Cardiology The Jiangmen Central Hospital The Jiangmen Central Hospital of Sun Yat‐Set University Jiangmen China
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Pouladzadeh M, Safdarian M, Choghakabodi PM, Amini F, Sokooti A. Validation of red cell distribution width as a COVID-19 severity screening tool. Future Sci OA 2021; 7:FSO712. [PMID: 34254030 PMCID: PMC8056748 DOI: 10.2144/fsoa-2020-0199] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/29/2021] [Indexed: 12/12/2022] Open
Abstract
AIM The aim of this study is the predictive validation of red cell distribution width (RDW) in COVID-19 patients. METHOD In total, 331 COVID-19 patients were classified as 'severe' and 'nonsevere' groups based on the WHO standard criteria. The levels of RDW standard deviation (SD) were evaluated as both continuous and categorical variables. Multivariate statistical analyses were used. RESULTS RDW-SD ≤43 and ≤47 fl thresholds showed high specificity (90.1-91.4%) for diagnosing nonsevere illness and no risk of death. RDW-SD >47 indicated severe illness and a high mortality risk while 43 CONCLUSION RDW-SD levels may be a potent independent predictor of the infection severity and mortality probability in COVID-19 patients.
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Affiliation(s)
- Mandana Pouladzadeh
- Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Mehdi Safdarian
- Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Parastoo Moradi Choghakabodi
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Fatemeh Amini
- Department of Persian medicine, School of Medicine, Shiraz University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Alireza Sokooti
- Department of Pathology, Razi Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
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El-Marakby SM, Awad MM, Eraba KM, Abdelgawad MH, Desouky OS. Assessment of chronic exposure effects and radioadaptive response of natural occurring radioactive materials (NORM). Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.108502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Korur A, Yanardag Acik D, Solmaz S, Gereklioglu C, Asma S, Ozdogu H. A Novel Parameter for Predicting Therapeutic Response in Iron Deficiency Anemia: Red Blood Cell Distribution Width. EURASIAN JOURNAL OF FAMILY MEDICINE 2019. [DOI: 10.33880/ejfm.2019080303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Anemia is a public health problem worldwide. Cost effectiveness and efficient use of resources are vitally important. Red blood cell distribution width, which can be obtained from a standard complete blood count, is a measure of the variability in size of circulating erythrocytes. The present study was performed to investigate whether red blood cell distribution width can be used to predict response to iron therapy. Methods: This study was conducted in 50 patients admitted to hematology and family medicine clinics. Complete blood count and reticulocyte count were determined on day 5; complete blood count was examined 1 month after commencement of therapy. Results: Statistically significant differences were detected between hemoglobin levels and red blood cell distribution width values at the time of diagnosis and on day 5 and after 1 month of therapy. A significant positive correlation was found between the increase in red blood cell distribution width and the increase in hemoglobin. Conclusion: Red blood cell distribution width may be used in place of reticulocyte count to predict response to iron therapy. Red blood cell distribution width is the best biomarker for this purpose as a component of complete blood count, and therefore it may be accepted as superior to reticulocyte count.
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Affiliation(s)
- Aslı Korur
- Department of Family Medicine, Baskent University Faculty of Medicine
| | | | - Soner Solmaz
- Department of Hematology, Baskent University Faculty of Medicine
| | | | - Suheyl Asma
- Department of Family Medicine, Baskent University Faculty of Medicine
| | - Hakan Ozdogu
- Department of Hematology, Baskent University Faculty of Medicine
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Milas GP, Karageorgiou V, Cholongitas E. Red cell distribution width to platelet ratio for liver fibrosis: a systematic review and meta-analysis of diagnostic accuracy. Expert Rev Gastroenterol Hepatol 2019; 13:877-891. [PMID: 31389726 DOI: 10.1080/17474124.2019.1653757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Red cell distribution width to platelet ratio (RPR) may be a useful marker for the evaluation of liver fibrosis in chronic liver disease (CLD). We sought to investigate its value in fibrosis-related outcomes in a meta-analysis of diagnostic accuracy. Areas covered: We searched MEDLINE (1966-2019), Clinicaltrials.gov (2008-2019), Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2019), Google Scholar (2004-2019) and WHO (International Clinical Trials Register Platform) databases using a structured algorithm. The articles were assessed by Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). In over 1,800 patients for each outcome, pooled sensitivity and specificity for a) significant fibrosis, b) advanced fibrosis and c) cirrhosis were: a) 0.635 and 0.769 with an AUC of 0.747, b) 0.607 and 0.783 with an AUC of 0.773, c) 0.739 and 0.768 with an AUC of 0.818 respectively. Similar results were found for chronic hepatitis B in all outcomes. Subgroup analysis indicated a high specificity for advanced fibrosis detection in primary biliary cirrhosis. Sensitivity analysis did not alter the results. Expert opinion: RPR is a good predictor of fibrosis, especially as severity of chronic liver disease progresses. Future research should elucidate its value in specific etiologies of chronic liver disease.
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Affiliation(s)
- Gerasimos P Milas
- First Department of Internal Medicine, Medical School of National & Kapodistrian University, General Hospital of Athens "Laiko" , Athens , Greece
| | - Vasilios Karageorgiou
- First Department of Internal Medicine, Medical School of National & Kapodistrian University, General Hospital of Athens "Laiko" , Athens , Greece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Medical School of National & Kapodistrian University, General Hospital of Athens "Laiko" , Athens , Greece
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Zhang FX, Li ZL, Zhang ZD, Ma XC. Prognostic value of red blood cell distribution width for severe acute pancreatitis. World J Gastroenterol 2019; 25:4739-4748. [PMID: 31528098 PMCID: PMC6718036 DOI: 10.3748/wjg.v25.i32.4739] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/02/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Severe acute pancreatitis (SAP) is a common condition in the intensive care unit (ICU) and has a high mortality. Early evaluation of the severity and prognosis is very important for SAP therapy. Recently, red blood cell distribution (RDW) was associated with mortality of sepsis patients and could be used as a predictor of prognosis. Similarly, RDW may be associated with the prognosis of SAP patients and be used as a prognostic indicator for SAP patients.
AIM To investigate the prognostic value of RDW for SAP patients.
METHODS We retrospectively enrolled SAP patients admitted to the ICU of the First Affiliated Hospital of China Medical University from June 2015 to June 2017. According to the prognosis at 90 d, SAP patients were divided into a survival group and a non-survival group. RDW was extracted from a routine blood test. Demographic parameters and RDW were recorded and compared between the two groups. The receiver operator characteristic (ROC) curve was constructed and Cox regression analysis was performed to investigate the prognostic value of RDW for SAP patients.
RESULTS In this retrospective cohort study, 42 SAP patients were enrolled, of whom 22 survived (survival group) and 20 died (non-survival group). The baseline parameters were comparable between the two groups. The coefficient of variation of RDW (RDW-CV), standard deviation of RDW (RDW-SD), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score were significantly higher in the non-survival group than in the survival group (P < 0.05). The RDW-CV and RDW-SD were significantly correlated with the APACHE II score and SOFA score, respectively. The areas under the ROC curves (AUCs) of RDW-CV and RDW-SD were all greater than those of the APACHE II score and SOFA score, among which, the AUC of RDW-SD was the greatest. The results demonstrated that RDW had better prognostic value for predicting the mortality of SAP patients. When the RDW-SD was greater than 45.5, the sensitivity for predicting prognosis was 77.8% and the specificity was 70.8%. Both RDW-CV and RDW-SD could be used as independent risk factors to predict the mortality of SAP patients in multivariate logistic regression analysis and univariate Cox proportional hazards regression analysis, similar to the APACHE II and SOFA scores.
CONCLUSION The RDW is greater in the non-surviving SAP patients than in the surviving patients. RDW is significantly correlated with the APACHE II and SOFA scores. RDW has better prognostic value for SAP patients than the APACHE II and SOFA scores and could easily be used by clinicians for the treatment of SAP patients.
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Affiliation(s)
- Fang-Xiao Zhang
- Department of Critical Care Medicine, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Zhi-Liang Li
- Department of Critical Care Medicine, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Zhi-Dan Zhang
- Department of Critical Care Medicine, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Xiao-Chun Ma
- Department of Critical Care Medicine, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Goswami B, Dhanuka A, Goswami S, Chakrabarti S. Profile of nutritional anemia and its correlation with serum iron, Vitamin B12, and folic acid level among the tribal population of northern districts of West Bengal, India. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2019. [DOI: 10.4103/amhs.amhs_45_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Piriyakhuntorn P, Tantiworawit A, Rattanathammethee T, Chai-Adisaksopha C, Rattarittamrong E, Norasetthada L. The role of red cell distribution width in the differential diagnosis of iron deficiency anemia and non-transfusiondependent thalassemia patients. Hematol Rep 2018; 10:7605. [PMID: 30283620 PMCID: PMC6151350 DOI: 10.4081/hr.2018.7605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/29/2018] [Indexed: 12/05/2022] Open
Abstract
This study aims to find the cut-off value and diagnostic accuracy of the use of RDW as initial investigation in enabling the differentiation between IDA and NTDT patients. Patients with microcytic anemia were enrolled in the training set and used to plot a receiving operating characteristics (ROC) curve to obtain the cut-off value of RDW. A second set of patients were included in the validation set and used to analyze the diagnostic accuracy. We recruited 94 IDA and 64 NTDT patients into the training set. The area under the curve of the ROC in the training set was 0.803. The best cut-off value of RDW in the diagnosis of NTDT was >21.0% with a sensitivity and specificity of 81.3% and 55.3% respectively. In the validation set, there were 34 IDA and 58 NTDT patients using the cut-off value of 21.0% to validate. The sensitivity, specificity, positive predictive value and negative predictive value were 84.5%, 70.6%, 83.1% and 72.7% respectively. We can therefore conclude that RDW >21.0% is useful in differentiating between IDA and NTDT patients with high diagnostic accuracy.
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Affiliation(s)
- Pokpong Piriyakhuntorn
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Tantiworawit
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thanawat Rattanathammethee
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chatree Chai-Adisaksopha
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekarat Rattarittamrong
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Lalita Norasetthada
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Abrahan LL, Ramos JDA, Cunanan EL, Tiongson MDA, Punzalan FER. Red Cell Distribution Width and Mortality in Patients With Acute Coronary Syndrome: A Meta-Analysis on Prognosis. Cardiol Res 2018; 9:144-152. [PMID: 29904449 PMCID: PMC5997444 DOI: 10.14740/cr732w] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022] Open
Abstract
Background Red cell distribution width (RDW), a routine component of the complete blood count (CBC), measures variation in the size of circulating erythrocytes. It has been associated with several clinical outcomes in cardiovascular disease. We sought to strengthen the association between RDW and mortality in patients admitted for acute coronary syndrome (ACS) by pooling together data from available studies. Methods Studies that fulfilled the following were identified for analysis: 1) observational; 2) included patients admitted for ACS; 3) reported data on all-cause or cardiovascular (CV) mortality in association with a low or high RDW; and 4) used logistic regression analysis to control for confounders. Using MEDLINE, Clinical Key, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials databases, a search for eligible studies was conducted until January 9, 2017. The quality of each study was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Our primary outcome of interest was all-cause or CV mortality. We also investigated the impact of RDW on major adverse cardiovascular events (MACEs) for the studies that reported these outcomes. Review Manager (RevMan) 5.3 was utilized to perform Mantel-Haenzel analysis of random effects and compute for relative risk. Results We identified 13 trials involving 10,410 patients, showing that in ACS, a low RDW is associated with a statistically significant lower all-cause or CV mortality (RR 0.35, (95% CI 0.30 to 0.40), P < 0.00001, I2 = 53%), a finding that was consistent both in the short- and long-term. Conclusions A low RDW is also associated with lower risk for MACEs after an ACS (RR 0.56, (95% CI 0.51 to 0.61), P < 0.00001, I2 = 91%). A low RDW during an ACS is associated with lower all-cause or CV mortality and lower risk of subsequent MACEs, providing us with a convenient and inexpensive risk stratification tool in ACS patients.
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Affiliation(s)
- Lauro L Abrahan
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - John Daniel A Ramos
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - Elleen L Cunanan
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - Marc Denver A Tiongson
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
| | - Felix Eduardo R Punzalan
- Section of Cardiology, University of the Philippines, Philippine General Hospital, Manila Philippines 1000, Philippines
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Red blood cell distribution width is associated with mortality in elderly patients with sepsis. Am J Emerg Med 2017; 36:949-953. [PMID: 29133071 DOI: 10.1016/j.ajem.2017.10.056] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/15/2017] [Accepted: 10/24/2017] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. METHODS This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015. Elderly patients (≥65years old) who were admitted to the ED-ICU with a diagnosis of severe sepsis and/or septic shock were included. The demographic data, biochemistry data, qSOFA, and APACHE II score were compared between survivors and nonsurvivors. RESULTS A total of 117 patients was included with mean age 81.5±8.3years old. The mean APACHE II score was 21.9±7.1. In the multivariate Cox proportional hazards model, RDW level was an independent variable for mortality (hazard ratio: 1.18 [1.03-1.35] for each 1% increase in RDW, p=0.019), after adjusting for CCI, any diagnosed malignancy, and eGFR. The AUC of RDW in predicting mortality was 0.63 (95% confidence interval [CI]: 0.52-0.74, p=0.025). In subgroup analysis, for qSOFA <2, nonsurvivors had higher RDW levels than survivors (17.0±3.3 vs. 15.3±1.4%, p=0.044). CONCLUSIONS In our study, RDW was an independent predictor of in-hospital mortality in elderly patients with sepsis. For qSOFA scores <2, higher RDW levels were associated with poor prognosis. RDW could be a potential parameter used alongside the clinical prediction rules.
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Xanthopoulos A, Giamouzis G, Melidonis A, Kitai T, Paraskevopoulou E, Paraskevopoulou P, Patsilinakos S, Triposkiadis F, Skoularigis J. Red blood cell distribution width as a prognostic marker in patients with heart failure and diabetes mellitus. Cardiovasc Diabetol 2017; 16:81. [PMID: 28683798 PMCID: PMC5501451 DOI: 10.1186/s12933-017-0563-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/20/2017] [Indexed: 02/08/2023] Open
Abstract
Background Red blood cell distribution width (RDW) is an established prognostic marker in acute and chronic heart failure (HF). Recent studies have pointed out a link among RDW, diabetes mellitus (DM) and inflammation. We sought to investigate the prognostic value and longitudinal pattern of RDW in patients with concomitant HF and DM, which remains unknown. Methods A total of 218 patients (71 diabetics) who presented with acute HF had RDW measured at admission, discharge and 4, 8 and 12 months post-discharge. The study endpoint was all-cause mortality or rehospitalization for HF during 1-year follow-up. Results The study endpoint was met in 33 patients (46.5%) with DM and in 54 patients (36.7%) without DM. RDW at admission was associated with higher event rate both in HF patients with and without DM (adjusted HR: 1.349, p = 0.002, 95% CI 1.120–1.624 and adjusted HR: 1.142, p = 0.033, 95% CI 1.011–1.291 respectively). In addition, a significant interaction was found between diabetes and RDW longitudinal changes (βinteraction = −0.002; SE = 0.001; p = 0.042). Conclusions Despite the similar prognostic significance of RDW in diabetic and non-diabetic HF patients regarding the study endpoint, longitudinal changes were found to be significantly different between these two groups of HF patients. This might be due to the higher inflammatory burden that diabetic HF patients carry and may provide new insights to the pathophysiological mechanism of RDW increase in HF, which remains unknown.
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Affiliation(s)
- Andrew Xanthopoulos
- Department of Cardiology, University General Hospital of Larissa, P.O. Box 1425, 411 10, Larissa, Greece.
| | - Gregory Giamouzis
- Department of Cardiology, University General Hospital of Larissa, P.O. Box 1425, 411 10, Larissa, Greece
| | | | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | | | | | - Filippos Triposkiadis
- Department of Cardiology, University General Hospital of Larissa, P.O. Box 1425, 411 10, Larissa, Greece
| | - John Skoularigis
- Department of Cardiology, University General Hospital of Larissa, P.O. Box 1425, 411 10, Larissa, Greece
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Akkermans MD, Uijterschout L, Nuijsink M, Hendriks DM, van Goudoever JB, Brus F. Red blood cell distribution width is not a reliable biomarker for low iron stores in children with cystic fibrosis. Pediatr Hematol Oncol 2017; 34:10-16. [PMID: 28276750 DOI: 10.1080/08880018.2016.1268226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Low iron stores in children, absolute iron deficiency (AID), can lead to impaired neurodevelopment and requires iron therapy. In the presence of infection/inflammation, like in cystic fibrosis (CF), serum ferritin (SF) is not a reliable biomarker for AID. Red blood cell distribution width (RDW) is a promising alternative reported not to be influenced by infection in healthy children. Currently, there are no data on the diagnostic capacity of RDW to detect AID in pediatric CF patients. This was a prospective observational study that investigated iron status biomarkers in 53 Dutch pediatric CF patients. AID was defined using World Health Organization criteria for SF in stable patients (no recent pulmonary exacerbation) and C-reactive protein (CRP) ≤10 mg/l. Patients with AID had higher RDW levels than patients without AID (p = 0.019). An RDW ≥13.2% showed the following test statistics: sensitivity 100%; specificity 39.4%; positive predictive value 20%; and negative predictive value 100%. Furthermore, we found a correlation between RDW and CRP in the total group that originated from the stable patients (r = 0.308; p = 0.042). In conclusion, the diagnostic capacity of RDW for detecting AID in pediatric CF patients seems limited because RDW levels might also be influenced by chronic infection/inflammation in these patients.
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Affiliation(s)
- M D Akkermans
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - L Uijterschout
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands.,b Department of Paediatrics , VU University Medical Centre , Amsterdam , The Netherlands
| | - M Nuijsink
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - D M Hendriks
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - J B van Goudoever
- b Department of Paediatrics , VU University Medical Centre , Amsterdam , The Netherlands.,c Department of Paediatrics , Emma Children's Hospital-Academic Medical Centre , Amsterdam , The Netherlands
| | - F Brus
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
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Akkermans MD, Uijterschout L, Vloemans J, Teunisse PP, Hudig F, Bubbers S, Verbruggen S, Veldhorst M, de Leeuw TG, van Goudoever JB, Brus F. Red Blood Cell Distribution Width and the Platelet Count in Iron-deficient Children Aged 0.5-3 Years. Pediatr Hematol Oncol 2016; 32:624-32. [PMID: 26558306 DOI: 10.3109/08880018.2015.1085935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Early detection of iron deficiency (ID) and iron deficiency anemia (IDA) in young children is important to prevent impaired neurodevelopment. Unfortunately, many biomarkers of ID are influenced by infection, thus limiting their usefulness. The aim of this study was to investigate the value of red blood cell distribution width (RDW) and the platelet count for detecting ID(A) among otherwise healthy children. A multicenter prospective observational study was conducted in the Netherlands to investigate the prevalence of ID(A) in 400 healthy children aged 0.5-3 years. ID was defined as serum ferritin (SF) <12 μg/L in the absence of infection (C-reactive protein [CRP] <5 mg/L) and IDA as hemoglobin <110 g/L combined with ID. RDW (%) and the platelet count were determined in the complete blood cell count. RDW was inversely correlated with SF and not associated with CRP. Calculated cutoff values for RDW to detect ID and IDA gave a relatively low sensitivity (53.1% and 57.1%, respectively) and specificity (64.7% and 69.9%, respectively). Anemic children with a RDW >14.3% had a 2.7 higher odds (95% confidence interval [CI]: 1.2-6.3) to be iron deficient, compared with anemic children with a RDW <14.3%. The platelet count showed a large range in both ID and non-ID children. In conclusion, RDW can be helpful for identifying ID as the cause of anemia in 0.5- to 3-year-old children, but not as primary biomarker of ID(A). RDW values are not influenced by the presence of infection. There appears to be no role for the platelet count in diagnosing ID(A) in this group of children.
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Affiliation(s)
- M D Akkermans
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - L Uijterschout
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - J Vloemans
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - P P Teunisse
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - F Hudig
- b Department of Clinical Chemistry , LabWest, Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - S Bubbers
- c Department of Anesthesiology , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
| | - S Verbruggen
- d Department of Paediatrics , Sophia Children's Hospital/Erasmus Medical Center , Rotterdam , The Netherlands
| | - M Veldhorst
- e Department of Paediatrics , VU University Medical Center , Amsterdam , The Netherlands
| | - T G de Leeuw
- f Department of Anesthesiology , Sophia Children's Hospital/Erasmus Medical Center , Rotterdam , The Netherlands
| | - J B van Goudoever
- e Department of Paediatrics , VU University Medical Center , Amsterdam , The Netherlands.,g Department of Paediatrics , Emma Children's Hospital-Academic Medical Center , Amsterdam , The Netherlands
| | - F Brus
- a Department of Paediatrics , Juliana Children's Hospital/Haga Teaching Hospital , The Hague , The Netherlands
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Su C, Liao LZ, Song Y, Xu ZW, Mei WY. The role of red blood cell distribution width in mortality and cardiovascular risk among patients with coronary artery diseases: a systematic review and meta-analysis. J Thorac Dis 2014; 6:1429-40. [PMID: 25364520 DOI: 10.3978/j.issn.2072-1439.2014.09.10] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 08/14/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Red cell distribution width (RDW) might be a novel biomarker that reflects multiple physiological impairments related to atherosclerosis and coronary artery diseases (CAD). We conducted this systematic review and meta-analysis to evaluate the association of RDW between all-cause mortality and fatal/non-fatal cardiovascular disease (CVD) events in CAD patients. METHODS Relevant studies were searched and identified in the MEDLINE and EMBASE databases. English-language prospective studies that reported risk estimates for RDW and mortality/CVD events were included. Data were extracted regarding the characteristics and clinical outcomes, and a quality assessment was conducted. Results were extracted for the highest versus lowest RDW level, and meta-analyses were carried out using random effects models. RESULTS We identified 22 studies enrolling 80,216 participants. The study duration ranged between 1 month and 23 years. Of the 15 studies that were included in the meta-analysis, higher RDW indicated a significant increased risk for all-cause mortality in CAD patients: pooled risk ratio (RR) 2.20 (95% CI, 1.42-3.39; P<0.0004). The results for fatal, non-fatal and fatal/non-fatal events were: pooled RR 1.80 (95% CI, 1.35-2.41; P<0.0001), RR 1.86 (95% CI, 1.50-2.31; P<0.00001) and RR 2.13 (95% CI, 1.20-3.77; P=0.01). Heterogeneity was moderately present; however, sensitivity analyses for follow-up duration, CAD subtype, or RDW as dichotomous values showed similar results. CONCLUSIONS The meta-analysis indicates that higher RDW levels are associated with increased risk of mortality and CVD events in patients with established CAD.
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Affiliation(s)
- Chang Su
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Li-Zhen Liao
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yan Song
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Zhi-Wei Xu
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Wei-Yi Mei
- 1 Department of Hematology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China ; 2 Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510080, China ; 3 Department of Pathophysiology, ZhongShan Medical College, Sun Yat-sen University, Guangzhou 510080, China ; 4 Department of Cardiology, Huangpu Division of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
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Dai Y, Konishi H, Takagi A, Miyauchi K, Daida H. Red cell distribution width predicts short- and long-term outcomes of acute congestive heart failure more effectively than hemoglobin. Exp Ther Med 2014; 8:600-606. [PMID: 25009627 PMCID: PMC4079416 DOI: 10.3892/etm.2014.1755] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 03/27/2014] [Indexed: 12/15/2022] Open
Abstract
The present study compared short- and long-term prognostic values of red blood cell distribution width (RDW) with those of hemoglobin (Hgb) among patients with acute congestive heart failure (CHF) in a cardiac care unit. The cross-sectional study examined data from 521 patients with acute CHF who were admitted to a cardiac care unit and followed up for 24 months (median). Mean Hgb levels in patients who succumbed (DIH) or remained alive (AIH) were 11.0±1.8 and 11.8±2.6 g/l (P>0.05), respectively. Median values of RDW were 16.2% and 14.4%, respectively (P<0.0001). During the 24-month follow-up, mean levels of Hgb in groups with and without endpoints were 11.4±2.5 and 12.5±2.4 g/dl (P<0.0001), respectively. Median RDW values were 14.9 and 13.8%, respectively (P<0.0001). Logistic regression analysis showed that in-hospital mortality was significantly associated with RDW (P=0.044), New York Heart Association (NYHA) functional class IV (P=0.0037), estimated glomerular filtration rate (eGFR) (P=0.042) and C-reactive protein (P=0.0044), but not with Hgb (P=0.10). The multivariate Cox proportional hazard model selected RDW [hazard ratio (HR), 2.19; P<0.0001], left ventricular ejection fraction (HR 0.81, P=0.0016), age (10-year increase; HR 1.19, P=0.0017) and NYHA functional classes III/IV (HR 1.52, P=0.0029) as independent predictors of long-term outcomes after adjustment, but not Hgb (HR 1.01, P=0.86). Higher RDW values in acute CHF patients at admission were associated with worse short- and long-term outcomes and RDW values were more prognostically relevant than Hgb levels.
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Affiliation(s)
- Yuxiang Dai
- Department of Cardiology, Juntendo University School of Medicine, Tokyo 113-8421, Japan ; Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Hakuoh Konishi
- Department of Cardiology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Atsutoshi Takagi
- Department of Cardiology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Katsumi Miyauchi
- Department of Cardiology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Hiroyuki Daida
- Department of Cardiology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
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Sazawal S, Dhingra U, Dhingra P, Dutta A, Shabir H, Menon VP, Black RE. Efficiency of red cell distribution width in identification of children aged 1-3 years with iron deficiency anemia against traditional hematological markers. BMC Pediatr 2014; 14:8. [PMID: 24428927 PMCID: PMC3897999 DOI: 10.1186/1471-2431-14-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/02/2014] [Indexed: 12/04/2022] Open
Abstract
Background Current strategy to identify iron deficiency anemia relies on markers involving high costs. Reports have suggested red cell distribution width (RDW) as a potential screening test for identifying iron deficiency anemia (IDA) but studies in pediatric populations are lacking. Our study elucidates the discriminative ability of RDW for detecting IDA among young children. Methods 2091 blood reports of children aged 1–3 years from an urban low socio-economic population of Delhi were analyzed to evaluate the sensitivity of RDW in discriminating IDA using receiver’s operating characteristic curve. Hemoglobin and RDW were estimated using coulter, zinc protoporphyrin with AVIV fluorometer and serum ferritin by enzyme linked immunosorbent assay. Results A total of 1026 samples were classified as iron deficient anemia using gold standard. As a marker of overall efficiency, area under the curve for RDW was 0.83 (95% CI, 0.81- 0.84; p < 0.001). Sensitivity of RDW at cut-off of 18% to detect iron deficiency anemia was 76.5% and specificity 73.1% yielding a positive predictive value of 73% and negative predictive value of 76%. At a cut-off of RDW 16.4%, the sensitivity was 94% and at a cut-off of 21%, the specificity was 95%. Combination of hemoglobin ≤10 g/dL and RDW >15%, yielded a sensitivity of 99% and specificity of 90%. These data suggest that simple coulter analysis estimating hemoglobin and RDW can be used for identification of children in need for iron therapy. Conclusions In India and similar settings, RDW >15% with hemoglobin ≤10.0 g/dL identifies iron deficient anemic children without need for iron status markers which could help reduce cost of management especially in poor settings. Trial registration Clinicaltrials.gov NCT00255385.
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Affiliation(s)
- Sunil Sazawal
- Center for Micronutrient Research, Annamalai University, Annamalai Nagar, India.
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17
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Saba F, Poornima S, Balaji PAR, Varne SRR, Jayashree K. Anemia among hospitalized children at a multispecialty hospital, bangalore (karnataka), India. J Family Med Prim Care 2014; 3:48-53. [PMID: 24791237 PMCID: PMC4005201 DOI: 10.4103/2249-4863.130275] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Due to the limited availability of data related to anemia in hospitalized children, this research was conducted to study the occurrence, morphological patterns, distribution in different age groups, sex, and severity of anemia among children aged 6 months-12 years. SETTING Inpatients in department of pediatrics at a multispecialty hospital, Bangalore. STUDY DESIGN Descriptive cross sectional study from Oct, 2011 to Sep, 2012. MATERIALS AND METHODS Ethical clearance was obtained from the ethical committee of the hospital as per 1964 Declaration of Helsinki. Unrestricted random sampling method was used to select the study group consisting of 882 children between the age of 6 months and 12 years. After obtaining the consent, data were obtained and statistically analyzed using statistical tools like mean, median, standard deviation, and Chi-square test. RESULTS Out of 882 children selected, 642 (72.79%) were anemic, out of which a majority of 629 (98%) children suffered from nonhemoglobinopathies and a meagre 13 (2%) suffered from hemoglobinopathies. Children in the age group of 6 months-1 year were most affected with nonhemoglobinopathies (33%). Moderate degree of anemia (hemoglobin = 7-9.9 g/dL) was the commonest grade of anemia (80%), while microcytic hypochromic anemia was commonest morphological type of anemia (48%). Among hemoglobinopathies, thalassemia major was the most common (69%, that is 9 out of 13 patients). CONCLUSION The occurrence of anemia among children aged between 6 months and 12 years is high and nonhemoglobinopathies predominate over the hemoglobinopathies.
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Affiliation(s)
- Firdos Saba
- Department of Pathology, Dr. Bhimrao Ramji Ambedkar Medical College, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Siddaraju Poornima
- Department of Physiology, Dr. Bhimrao Ramji Ambedkar Medical College, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Pishey Ashwathnarayan Rao Balaji
- Department of Physiology, Dr. Bhimrao Ramji Ambedkar Medical College, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Smitha Ranoji Rao Varne
- Department of Yoga and Nutrition, Healing Touch Yoga Centre and Nagal Diagnostics, Ayurveda Yoga and Naturopathy Unani Siddha and Homoeopathy, Bangalore, India
| | - Krishnamurthy Jayashree
- Department of Pathology, Jagadguru Sri Shivarathreeshwara Medical College, Jan Shikshan Sansthan University, Mysore, Karnataka, India
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18
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Celikbilek A, Zararsiz G, Atalay T, Tanik N. Red cell distribution width in migraine. Int J Lab Hematol 2013; 35:620-8. [DOI: 10.1111/ijlh.12100] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Celikbilek
- Department of Neurology; Bozok University; Yozgat Turkey
| | - G. Zararsiz
- Department of Biostatistics and Medical Informatics; Erciyes University; Kayseri Turkey
| | - T. Atalay
- Department of Neurosurgery; Bozok University; Yozgat Turkey
| | - N. Tanik
- Department of Neurology; Bozok University; Yozgat Turkey
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Abdelrahman EG, Gasim GI, Musa IR, Elbashir LM, Adam I. Red blood cell distribution width and iron deficiency anemia among pregnant Sudanese women. Diagn Pathol 2012. [PMID: 23206545 PMCID: PMC3538607 DOI: 10.1186/1746-1596-7-168] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is a major health problem during pregnancy and it has adverse effects on the mother and the newborn. Red cell distribution width (RDW), which is a quantitative measure for red cell size variation (anisocytosis), is a predictor of IDA. Little is known regarding RDW and IDA during pregnancy. METHODS A cross sectional study was conducted at the antenatal clinic of Khartoum Hospital, Sudan, to determine the performance of RDW in the diagnosis of IDA using serum ferritin as a gold standard. RESULTS Among 194 pregnant women with a gestational period of 21.4 ± 6.5 weeks, 57 (29.4%) had IDA according to serum ferritin levels (<15 μg/l) and 61 (31.4%) had IDA according to RDW (>14.5). The sensitivity, specificity, positive predictive value, and negative predictive value of RDW where serum ferritin was the gold standard were 43.8% (95% CI: 31.4-57.0%), 73.7% (95% CI: 65.8-80.5%), 41.0% (95% CI: 29.2-53.6%), and 76.0% (95% CI: 68.1-82.6%), respectively. CONCLUSIONS In this study, we found that RDW has a poor performance in diagnosing IDA among pregnant women compared with serum ferritin as the gold standard.
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Hartfield DS, Tan J, Yager JY, Rosychuk RJ, Spady D, Haines C, Craig WR. The association between iron deficiency and febrile seizures in childhood. Clin Pediatr (Phila) 2009; 48:420-6. [PMID: 19229063 DOI: 10.1177/0009922809331800] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to determine the association between iron deficiency and febrile seizures in a large cohort of children aged 6 to 36 months. METHODS A retrospective case control study with 361 patients who presented with febrile seizures to the emergency department and 390 otherwise healthy controls who presented with a febrile illness to the emergency department were reviewed to determine iron status using the MCV, RDW, and hemoglobin. RESULTS A total of 9% of cases had iron deficiency (ID) and 6% had iron deficiency anemia (IDA), compared to 5% and 4% of controls respectively. The conditional logistic regression odds ratio for ID in patients with febrile seizures was 1.84 (95% CI, 1.02-3.31). CONCLUSION Children with febrile seizures were almost twice as likely to be iron deficient as those with febrile illness alone. The results suggest that screening for ID should be considered in children presenting with febrile seizure.
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Affiliation(s)
- Dawn S Hartfield
- Department of Pediatrics, University of Alberta, Edmonton, Canada.
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21
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Aulakh R, Sohi I, Singh T, Kakkar N. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia. Indian J Pediatr 2009; 76:265-8. [PMID: 19205647 DOI: 10.1007/s12098-009-0014-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 05/07/2008] [Indexed: 10/21/2022]
Abstract
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. CONCLUSION RDW has a limited specificity for diagnosis of IDA among children with microcytic hypochromic anemia.
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Affiliation(s)
- Roosy Aulakh
- Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, Punjab, India
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22
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Bhatti AS, Mahida VI, Gupte SC. Iron status of Hindu brahmin, Jain and Muslim communities in Surat, Gujarat. Indian J Hematol Blood Transfus 2008; 23:82-7. [PMID: 23100921 DOI: 10.1007/s12288-008-0004-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AIM OF THE STUDY To determine iron status of healthy, unrelated Brahmin, Jain and Muslim participants having different dietary habits. METHODOLOGY Control participants other than above three communities, consumed vegetarian or non-vegetarian diet. Brahmin and Jain were strictly vegetarian but Jain did not consume roots or tubers. Muslims consumed non-vegetarian food. Standard techniques were used to measure hematological parameters, serum iron, total iron bindings capacity (TIBC), serum ferritin, transferrin and transferrin saturation. For statistical evaluation mean, standard deviation, pair t test, χ2 and ANOVA (F test) were employed. RESULTS Study includes 565 male and 198 female children and adults. Among them 205 were children and remaining adults. All four categories i.e. control, Brahmin, Jain and Muslims showed higher incidence of anemia and iron deficiency in females compared to males. Mean values of hematological parameters did not vary significantly in four groups. Serum iron, TIBC, transferrin and ferritin levels indicated iron deficiency anemia more frequently in Jains and less frequently in Muslims (p<0.05). Iron status of Brahmin was comparable with controls (p<0.01). Majority of the participants had serum ferritin concentration >15 ng/mL. Except one male Jain child none of the participants had serum ferritin concentration <12 ng/mL. Jain subjects more frequently had serum iron concentration <60 μg/dL. CONCLUSION Jain participants had higher incidence of iron deficiency anemia. Vegetarian diet consumed by Gujarati Hindu Brahmin community provided them with a sufficient iron to maintain their iron profile like Muslims consuming non-vegetarian diet.
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Affiliation(s)
- A S Bhatti
- Surat Raktadan Kendra & Research Centre, B/h. T. & T. V. Middle School, Gopipura, Surat, 395 001 India
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Mamtani M, Jawahirani A, Das K, Rughwani V, Kulkarni H. Bias-corrected diagnostic performance of the naked-eye single-tube red-cell osmotic fragility test (NESTROFT): an effective screening tool for beta-thalassemia. ACTA ACUST UNITED AC 2007; 11:277-86. [PMID: 17178668 DOI: 10.1080/10245330600915875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
It is being increasingly recognized that a majority of the countries in the thalassemia-belt need a cost-effective screening program as the first step towards control of thalassemia. Although the naked eye single tube red cell osmotic fragility test (NESTROFT) has been considered to be a very effective screening tool for beta-thalassemia trait, assessment of its diagnostic performance has been affected with the reference test- and verification-bias. Here, we set out to provide estimates of sensitivity and specificity of NESTROFT corrected for these potential biases. We conducted a cross-sectional diagnostic test evaluation study using data from 1563 subjects from Central India with a high prevalence of beta-thalassemia. We used latent class modelling after ensuring its validity to account for the reference test bias and global sensitivity analysis to control the verification bias. We also compared the results of latent class modelling with those of five discriminant indexes. We observed that across a range of cut-offs for the mean corpuscular volume (MCV) and the hemoglobin A2 (HbA2) concentration the average sensitivity and specificity of NESTROFT obtained from latent class modelling was 99.8 and 83.7%, respectively. These estimates were comparable to those characterizing the diagnostic performance of HbA2, which is considered by many as the reference test to detect beta-thalassemia. After correction for the verification bias these estimates were 93.4 and 97.2%, respectively. Combined with the inexpensive and quick disposition of NESTROFT, these results strongly support its candidature as a screening tool-especially in the resource-poor and high-prevalence settings.
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Soung DY, Patade A, Khalil DA, Lucas EA, Devareddy L, Greaves KA, Arjmandi BH. Soy protein supplementation does not cause lymphocytopenia in postmenopausal women. Nutr J 2006; 5:12. [PMID: 16608514 PMCID: PMC1481570 DOI: 10.1186/1475-2891-5-12] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 04/11/2006] [Indexed: 12/02/2022] Open
Abstract
Background The health benefits of soy isoflavones have been widely investigated; however, there are some concerns as to whether soy isoflavones, similar to ipriflavone, a synthetic isoflavone, cause lymphocytopenia in postmenopausal women. Hence, the purpose of this study was to investigate the extent to which 12-month supplementation of 25 g soy protein containing 60 mg isoflavones alters lymphocyte counts or other hematological parameters in postmenopausal women who were not on hormone replacement therapy. Methods Eighty-seven postmenopausal women were randomly assigned to receive either soy protein or an equivalent amount of control protein devoid of isoflavones. Fasting venous blood was collected at baseline and at the end of twelve month study period for complete blood count analyses. Results Between the two treatment groups, the percent changes in hematological parameters, including lymphocytes, were not different. While women consuming the soy supplement had an increase in mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width index (RDW; a marker of reticulocytes), women consuming the control diet had higher percentage of only MCHC. Conclusion Overall, the results of the present study indicate that consumption of 25 g soy protein containing 60 mg isoflavones daily for one year does not cause lymphocytopenia.
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Affiliation(s)
- Do Y Soung
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Anagha Patade
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Dania A Khalil
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Edralin A Lucas
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Latha Devareddy
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | | | - Bahram H Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
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