Clinical Investigation
Value of Red Cell Distribution Width for Assessing Disease Activity in Crohn's Disease

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Abstract

Background

Correlation between red cell distribution width (RDW) and chronic inflammation was observed, although studies focused on value of RDW for assessing disease activity in Crohn's disease (CD) are limited.

Methods

This is a prospective study. RDW, C-reactive protein, erythrocyte sedimentation rate and white blood cell count were measured in 100 patients with CD on admission and 102 age- and gender-matched healthy volunteers. value of these markers for assessing disease activity in CD was investigated.

Results

RDW was significantly higher in patients with active CD than in inactive patients (P < 0.05). The optimal cutoff value for RDW was 15.6% in differentiating active from inactive disease, with sensitivity and specificity of 94.2% and 56.3%, respectively (area under the curve = 0.743). The overall accuracy of RDW in detecting active CD was 76.0%, which is higher than that of erythrocyte sedimentation rate (68.0%) and white blood cell count (51.0%) but lower than that of C-reactive protein (78.0%).

Conclusions

RDW was elevated in patients with active CD in comparison with patients in remission. As a cost-effective tool, RDW may assist in determining the disease activity of CD.

Section snippets

Study Population

Between January 2012 and July 2013, a total of 100 patients with CD (age range from 16 to 70 years) were included prospectively. The diagnosis of CD was previously made according to conventional clinical, radiologic, endoscopic and histopathologic findings.12 In addition, 102 age- and gender-matched healthy subjects participated in the study.

The exclusion criteria included (1) hemoglobinopathy or thalassemia trait; (2) history of gastrointestinal bleeding; (3) malignancy, cardiovascular

RESULTS

The mean age of enrolled patients with CD was 33.2 ± 0.9 years and the ratio of male to female is 2.03 (67/33). No significant differences were found between the patients with CD compared with the control group subjects in age, gender or smoking history. Demographic and clinical characteristics of patients with CD and healthy controls are shown in Table 1.

DISCUSSION

In this study, we observed a significant increase in RDW in the active disease periods of CD compared with patients in remission. Receiver operating characteristic curve analysis showed that RDW may be a sensitive but not a specific marker (sensitivity 94.2%, specificity 56.3%) for determining active CD.

To our knowledge, only few studies investigated RDW in patients with CD.14., 15., 16., 17., 18., 19. Clarke et al19 published the 1st study related to RDW with inflammatory bowel disease (IBD),

CONCLUSIONS

It seems that RDW may assist in determining the disease activity of CD, which indicates a possible role of RDW to predict relapse and to monitor therapy. Finally, clinicians should pay more attention to the RDW level during their assessments of patients with CD.

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  • Cited by (10)

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    Supported By Grants From The National Nature Science Foundation Of China (81270478/H0312).

    The authors have no conflicts of interest to disclose.

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