Utility of red cell distribution width in screening for iron deficiency
- 1Department of Paediatric Haematology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
- 2School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
- 3Division of Infectious Disease, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
- 4Clinical Pharmacology Unit, Department of Human Metabolism, University of Sheffield Medical School, Sheffield, UK
- Correspondence to Dr Lynne Lennard, Clinical Pharmacology Unit, Department of Human Metabolism, Floor E, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK;
- Received 5 October 2012
- Revised 26 February 2013
- Accepted 12 April 2013
- Published Online First 22 May 2013
Aims To assess the sensitivity of an adult-derived red cell distribution width (RDW) reference limit in the detection of iron deficiency in young children.
Methods Haematological analysis performed on a cohort of 13-month-old healthy term infants of North European ancestry.
Results 21/98 infants were iron-deficient (>2.5% hypochromic red cells). Of the remaining 77, 35 with RDW >13.9% also had evidence of incipient iron deficiency on the basis of significantly lower haemoglobin (11.5 vs 11.8 g/dl, p=0.046), mean cell volume (75.6 vs 77.8 fl, p=0.002) and mean cell haemoglobin (25.4 vs 26.2 pg, p=0.002) values and higher zinc protoporphyrin (55 vs 44 μmol/molhaem, p<0.001) values than those of the 42 with RDW ≤13.9%.
Conclusions An adult-derived RDW reference limit has utility in screening for iron deficiency at the age of 13 months. The incidence of non-anaemic iron deficiency in this group was 52.8%.