Red blood cell distribution width

{{short description|Measure of red blood cell volume variation as part of a standard blood test}}

{{Use dmy dates|date=October 2018}}

{{Infobox diagnostic

| name = Red blood cell distribution width

| image = Redbloodcells.jpg

| alt =

| caption = Human red blood cells

| pronounce =

| purpose = measure of the range of variation of red blood cell volume that is reported as part of a standard complete blood count.

| test of =

|synonyms = RCDW

}}

Red blood cell distribution width (RDW), as well as various types thereof (RDW-CV or RCDW and RDW-SD), is a measure of the range of variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count.{{cite journal | vauthors = Nah EH, Kim S, Cho S, Cho HI | title = Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea | journal = Annals of Laboratory Medicine | volume = 38 | issue = 6 | pages = 503–511 | date = November 2018 | pmid = 30027692 | pmc = 6056383 | doi = 10.3343/alm.2018.38.6.503 | first5 = Seon | first7 = and Han-Ik }} Red blood cells have an average volume of 80–100 femtoliters, but individual cell volumes vary even in healthy blood. Certain disorders, however, cause a significantly increased variation in cell size. Higher RDW values indicate greater variation in size. Normal reference range of RDW-CV in human red blood cells is 11.5–15.4%.{{Cite web |title=Red Cell Distribution Width |url=http://www.fpnotebook.com/hemeonc/lab/RdClDstrbtnWdth.htm |website=Family Practice Notebook |access-date=18 October 2013}} If anemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anemia. It is mainly used to differentiate an anemia of mixed causes from an anemia of a single cause.

Deficiencies of Vitamin B₁₂ or folate produce a macrocytic anemia (large cell anemia) in which the RDW is elevated in roughly two-thirds of all cases. However, a varied size distribution of red blood cells is a hallmark of iron deficiency anemia, and as such shows an increased RDW in virtually all cases. In the case of both iron and B₁₂ deficiencies, there will normally be a mix of both large cells and small cells, causing the RDW to be elevated. An elevated RDW (red blood cells of unequal sizes) is known as anisocytosis.{{cite journal | vauthors = Evans TC, Jehle D | title = The red blood cell distribution width | journal = The Journal of Emergency Medicine | volume = 9 | issue = Suppl 1 | pages = 71–4 | year = 1991 | pmid = 1955687 | doi = 10.1016/0736-4679(91)90592-4 }}

An elevation in the RDW is not characteristic of all anemias. Anemia of chronic disease, hereditary spherocytosis, acute blood loss, aplastic anemia (anemia resulting from an inability of the bone marrow to produce red blood cells), and certain hereditary hemoglobinopathies (including some cases of thalassemia minor) may all present with a normal RDW.{{cite book | vauthors = Kjeldsberg CR, Perkins SL | chapter = Table 1.4 |title=Practical Diagnosis of Hematologic Disorders |date=2010 |publisher=ASCP Press |location=Chicago, IL |isbn=978-0-89189-571-8 |edition=5th | url= http://www.ascp.org/pdf/SneekPeekPracDiagofHemDisorders.aspx | archive-url = https://web.archive.org/web/20130725024821/http://www.ascp.org/pdf/SneekPeekPracDiagofHemDisorders.aspx | archive-date = 2013-07-25 }}