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Utility of red cell distribution width in screening for iron deficiency
  1. Roderick F Hinchliffe1,
  2. Graham J Bellamy1,
  3. Adam Finn2,
  4. Frank Bell3,
  5. Ajay J Vora1,
  6. Lynne Lennard4
  1. 1Department of Paediatric Haematology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
  2. 2School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
  3. 3Division of Infectious Disease, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
  4. 4Clinical Pharmacology Unit, Department of Human Metabolism, University of Sheffield Medical School, Sheffield, UK
  1. 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; l.lennard{at}


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%.

  • Haematology
  • Neurodevelopment

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