The Experts below are selected from a list of 270 Experts worldwide ranked by ideXlab platform
Ishag Adam - One of the best experts on this subject based on the ideXlab platform.
-
Red blood cell distribution width is not correlated with preeclampsia among pregnant Sudanese women
Diagnostic pathology, 2014Co-Authors: Hala Abdullahi, Gasim I. Gasim, Ameer Osman, Duria A. Rayis, Abdulmutalab M Imam, Ishag AdamAbstract:Background Preeclampsia is a leading cause of maternal and perinatal mortality worldwide. The exact etiology of preeclampsia is unknown, but the inflammatory process is postulated as one of the etiologies. Red blood cell distribution width (RDW) is a measure of Anisocytosis (variation of red cell size) and is associated with hypertension and diabetic ketoacidosis. There are few data on the association between RDW and preeclampsia. This study aimed to investigate the association between RDW and preeclampsia.
-
Red blood cell distribution width and iron deficiency anemia among pregnant Sudanese women
Diagnostic pathology, 2012Co-Authors: Esam G Abdelrahman, Gasim I. Gasim, Imad R. Musa, Leana M Elbashir, Ishag AdamAbstract: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.
Giuseppe Lippi - One of the best experts on this subject based on the ideXlab platform.
-
Red blood cell distribution width in heart failure: A narrative review.
World journal of cardiology, 2018Co-Authors: Giuseppe Lippi, Gianfranco Cervellin, Gianni Turcato, Fabian Sanchis-gomarAbstract:The red blood cell distribution width (RDW) is a simple, rapid, inexpensive and straightforward hematological parameter, reflecting the degree of Anisocytosis in vivo. The currently available scientific evidence suggests that RDW assessment not only predicts the risk of adverse outcomes (cardiovascular and all-cause mortality, hospitalization for acute decompensation or worsened left ventricular function) in patients with acute and chronic heart failure (HF), but is also a significant and independent predictor of developing HF in patients free of this condition. Regarding the biological interplay between impaired hematopoiesis and cardiac dysfunction, many of the different conditions associated with increased heterogeneity of erythrocyte volume (i.e., ageing, inflammation, oxidative stress, nutritional deficiencies and impaired renal function), may be concomitantly present in patients with HF, whilst Anisocytosis may also directly contribute to the development and worsening of HF. In conclusion, the longitudinal assessment of RDW changes over time may be considered an efficient measure to help predicting the risk of both development and progression of HF.
-
Prognostic significance of red blood cell distribution width in gastrointestinal disorders
World journal of gastroenterology, 2017Co-Authors: Hemant Goyal, Giuseppe Lippi, Altin Gjymishka, Bijo John, Rajiv Chhabra, Elizabeth MayAbstract:The red blood cell distribution width (RDW) is a routinely measured and automatically reported blood parameter, which reflects the degree of Anisocytosis. Recently, the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases, sepsis, cancers, leukemia, renal dysfunction and respiratory diseases. A myriad of factors, most of which ill-defined, have an impact on the red cell population dynamics (i.e., production, maturation and turnover). A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased Anisocytosis. Further study of RDW may reveal new insight into inflammation mechanisms. In this review, we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems. We also present some of the related measurements for their value in predicting clinical outcomes in such conditions. According to our data, RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers (i.e., C reactive protein, erythrocyte sedimentation rate, and platelet count) and current disease severity indices used in clinical practice.
-
Learning more and spending less with neglected laboratory parameters: the paradigmatic case of red blood cell distribution width
Acta bio-medica : Atenei Parmensis, 2016Co-Authors: Giuseppe Lippi, Camilla Mattiuzzi, Gianfranco CervellinAbstract:Due to increasing shortage of public healthcare resources in many countries around the globe, the use of simple, rapid and inexpensive laboratory parameters may be seen as a valuable aid for preliminary and cost-effective risk stratification of patients. Anisocytosis, conventionally measured by hematologic analyzers as the red blood cell distribution width (RDW), is an index of the heterogeneity of erythrocytes volumes. Several lines of evidence now attest that increased RDW values are commonplace in patients with many disorders, especially in those with the most prevalent conditions such as cardiovascular disease, diabetes, cancer and infections. Although the nature of this association remains to be definitely disclosed, what is strongly emerging from the recent scientific research is that the RDW should now be regarded as a "non" innocent bystander, wherein Anisocytosis may be an active player in the pathogenesis of many pathologies. Therefore, major attention should be placed on this inexpensive but clinically meaningful parameter. The recent finding that dynamic changes of RDW are strongly predictors of mortality also suggests that continuous monitoring of Anisocytosis may be an ancillary useful tool for establishing the effectiveness of managed care, as well as for deciding whether or not the overall clinical status is improving.
-
red blood cell distribution width a simple parameter with multiple clinical applications
Critical Reviews in Clinical Laboratory Sciences, 2015Co-Authors: Gian Luca Salvagno, Fabian Sanchisgomar, Alessandra Picanza, Giuseppe LippiAbstract:AbstractThe red blood cell distribution width (RDW) is a simple and inexpensive parameter, which reflects the degree of heterogeneity of erythrocyte volume (conventionally known as Anisocytosis), and is traditionally used in laboratory hematology for differential diagnosis of anemias. Nonetheless, recent evidence attests that Anisocytosis is commonplace in human disorders such as cardiovascular disease, venous thromboembolism, cancer, diabetes, community-acquired pneumonia, chronic obstructive pulmonary disease, liver and kidney failure, as well as in other acute or chronic conditions. Despite some demographic and analytical issues related to the routine assessment that may impair its clinical usefulness, an increased RDW has a high negative predictive value for diagnosing a variety of disorders, but also conveys important information for short- and long-term prognosis. Even more importantly, the value of RDW is now being regarded as a strong and independent risk factor for death in the general population...
-
Red blood cell distribution width and cardiovascular diseases.
Journal of thoracic disease, 2015Co-Authors: Elisa Danese, Giuseppe Lippi, Martina MontagnanaAbstract:Background: The red blood cell distribution width (RDW) is a rather simple measure of red blood cell (RBC) size heterogeneity (i.e., Anisocytosis), which is easily calculated by dividing the standard deviation (SD) of erythrocyte volumes for the mean corpuscular volume (MCV). Emerging evidence suggests that, besides RBC abnormalities, many human disorders may be frequently associated with a high degree of Anisocytosis. Methods: In this narrative review, we analyzed the current scientific literature about the putative role and the potential epidemiologic association between RDW and cardiovascular diseases. The findings of the most representative epidemiological studies were summarized and discussed. Results: Overall, considerable and convincing evidence has been brought that an increased RDW value is associated with acute coronary syndrome (ACS) [including acute myocardial infarction (AMI)], ischemic cerebrovascular disease (including stroke), peripheral artery disease (PAD), as well as with atrial fibrillation (AF), heart failure (HF) and hypertension. Higher Anisocytosis also significantly and independently predicts adverse outcomes in patients with these conditions. Conclusions: Although the role of Anisocytosis in the pathogenesis of cardiovascular diseases remains uncertain, the considerable evidence available so far suggests that the clinical use of RDW may be broadened beyond the conventional boundaries of erythrocyte disorders, in particular for assisting the diagnosis and prognostication of patients with ACS, ischemic cerebrovascular disease, PAD, HF and AF.
Swati Goel - One of the best experts on this subject based on the ideXlab platform.
-
Anisocytosis is a poor prognostic factor in secondary polycythemia.
Leukemia & lymphoma, 2019Co-Authors: Jose Nahun Galeas, Amit Verma, Nilupa Gaspe, Kith Pradhan, Hernando Cordero, Swati GoelAbstract:Red cell distribution width (RDW) is a ubiquitously reported laboratory value; it is a measure of the range of variation of red blood cell volume that is reported as part of a standard complete blo...
-
Anisocytosis Predicts Worse Survival in Secondary Polycythemia
Blood, 2016Co-Authors: Jose Nahun Galeas, Amit Verma, Nilupa Gaspe, Kith Pradhan, Hernando Cordero, Anjali Budhathoki, Swati GoelAbstract:Background: Red cell overproduction in certain lung and heart conditions causing hypoxia is a well-known entity. This mechanism is thought to be compensatory to the chronic hypoxia. But how this red cell overproduction and other red cell variables affect the morbidity and mortality of these secondary or reactive erythrocytosis patients has not been studied. Our goal is to see the effect of red cell parameters and other routinely obtained laboratory values in the clinical outcomes of secondary erythrocytosis patients in our ethnically diverse and large urban population. Methods: Patients ≥ 18 years of age seen at our center from 1998 to 2015 with a diagnosis of polycythemia or erythrocytosis, either primary or secondary, with follow up of at least one year, were included. This was done with the help of Clinical Looking Glass software after obtaining Institutional Review Board approval. Secondary erythrocytosis was confirmed by evaluating each medical record in detail. After confirming diagnosis, further evaluation and data collection were obtained including demographic variables, the following lab values at diagnosis and the mean values since diagnosis: Hemoglobin (Hb), Mean Corpuscular Volume( MCV), Red Cell Distribution Width ( RDW), White Blood Cell counts ( WBC), platelet counts and albumin level. All analyses were conducted using STATA statistical software. Kaplan-Meier curves were constructed to compare survival by various subgroups. Hazard ratios were calculated using multivariate Cox regression models to adjust for co-variates to compare mortality risk and identify potential independent predictors of mortality. Results: 190 patients with secondary erythrocytosis and 69 patients with Primary Polycythemia Vera were included in the study. Our population with secondary erythrocytosis consisted of 48 % Hispanic, 27 % Caucasian and 25% African American subjects. The main causes of secondary erythrocytosis were Lung and cardiac diseases, namely Chronic Obstructive Pulmonary Disease (COPD) in 29% and Obstructive Sleep Apnea (OSA) in 15%. Figure 1 depicts the various causes of secondary erythrocytosis. We found significant higher survival in patients with secondary erythrocytosis compared to Primary Polycythemia Vera (p value: 0.05) as shown in Figure 2a. Amongst the various laboratory parameters, the strongest interaction with the disease status was of mean RDW with secondary erythrocytosis. Subjects with high mean RDW had significantly worse survival in the secondary erythrocytosis group with a p value of 1.02*10-6. Another intriguing finding was that higher hemoglobin levels, both at diagnosis and mean values, were not associated with worse survival in these patients. When we further evaluated secondary erythrocytosis patients with high RDW (> 16.1) to normal RDW, there was a very significantly worse survival in patients with high RDW (p-value = 7*10-5). Also, when we compared secondary erythrocytosis with high RDW and Primary Polycythemia patients, there was no difference in survival (Figures 2b and c). Conclusions: This is a novel study in a minority rich population regarding the different common lab parameters in secondary erythrocytosis. RDW is a ubiquitously reported lab value. RDW is a measure of the range of variation of red blood cell volume that is reported as part of a standard complete blood count. Anisocytosis is when RBCs are of unequal sizes, thus equivalent to high RDW. Increased RDW has been linked to worse survival in various lung and heart diseases in the past. Our study proves this concept in the patients with reactive erythrocytosis often found in advanced lung and heart disease patients. Furthermore, our study gives a very strong possible explanation for this finding; that disordered overproduction of red blood cells under the stress of chronic hypoxia leads to higher RDW. The degree of hypoxia and resulting dyserythropoiesis might not be very obvious to the treating clinician and observing the trend of RDW could be very helpful in these situations. We conclude that high RDW in patients with secondary erythrocytosis should be taken very seriously and all attempts should be made to treat the underlying condition causing high hemoglobin. Disclosures No relevant conflicts of interest to declare.
Jose Nahun Galeas - One of the best experts on this subject based on the ideXlab platform.
-
Anisocytosis is a poor prognostic factor in secondary polycythemia.
Leukemia & lymphoma, 2019Co-Authors: Jose Nahun Galeas, Amit Verma, Nilupa Gaspe, Kith Pradhan, Hernando Cordero, Swati GoelAbstract:Red cell distribution width (RDW) is a ubiquitously reported laboratory value; it is a measure of the range of variation of red blood cell volume that is reported as part of a standard complete blo...
-
Anisocytosis Predicts Worse Survival in Secondary Polycythemia
Blood, 2016Co-Authors: Jose Nahun Galeas, Amit Verma, Nilupa Gaspe, Kith Pradhan, Hernando Cordero, Anjali Budhathoki, Swati GoelAbstract:Background: Red cell overproduction in certain lung and heart conditions causing hypoxia is a well-known entity. This mechanism is thought to be compensatory to the chronic hypoxia. But how this red cell overproduction and other red cell variables affect the morbidity and mortality of these secondary or reactive erythrocytosis patients has not been studied. Our goal is to see the effect of red cell parameters and other routinely obtained laboratory values in the clinical outcomes of secondary erythrocytosis patients in our ethnically diverse and large urban population. Methods: Patients ≥ 18 years of age seen at our center from 1998 to 2015 with a diagnosis of polycythemia or erythrocytosis, either primary or secondary, with follow up of at least one year, were included. This was done with the help of Clinical Looking Glass software after obtaining Institutional Review Board approval. Secondary erythrocytosis was confirmed by evaluating each medical record in detail. After confirming diagnosis, further evaluation and data collection were obtained including demographic variables, the following lab values at diagnosis and the mean values since diagnosis: Hemoglobin (Hb), Mean Corpuscular Volume( MCV), Red Cell Distribution Width ( RDW), White Blood Cell counts ( WBC), platelet counts and albumin level. All analyses were conducted using STATA statistical software. Kaplan-Meier curves were constructed to compare survival by various subgroups. Hazard ratios were calculated using multivariate Cox regression models to adjust for co-variates to compare mortality risk and identify potential independent predictors of mortality. Results: 190 patients with secondary erythrocytosis and 69 patients with Primary Polycythemia Vera were included in the study. Our population with secondary erythrocytosis consisted of 48 % Hispanic, 27 % Caucasian and 25% African American subjects. The main causes of secondary erythrocytosis were Lung and cardiac diseases, namely Chronic Obstructive Pulmonary Disease (COPD) in 29% and Obstructive Sleep Apnea (OSA) in 15%. Figure 1 depicts the various causes of secondary erythrocytosis. We found significant higher survival in patients with secondary erythrocytosis compared to Primary Polycythemia Vera (p value: 0.05) as shown in Figure 2a. Amongst the various laboratory parameters, the strongest interaction with the disease status was of mean RDW with secondary erythrocytosis. Subjects with high mean RDW had significantly worse survival in the secondary erythrocytosis group with a p value of 1.02*10-6. Another intriguing finding was that higher hemoglobin levels, both at diagnosis and mean values, were not associated with worse survival in these patients. When we further evaluated secondary erythrocytosis patients with high RDW (> 16.1) to normal RDW, there was a very significantly worse survival in patients with high RDW (p-value = 7*10-5). Also, when we compared secondary erythrocytosis with high RDW and Primary Polycythemia patients, there was no difference in survival (Figures 2b and c). Conclusions: This is a novel study in a minority rich population regarding the different common lab parameters in secondary erythrocytosis. RDW is a ubiquitously reported lab value. RDW is a measure of the range of variation of red blood cell volume that is reported as part of a standard complete blood count. Anisocytosis is when RBCs are of unequal sizes, thus equivalent to high RDW. Increased RDW has been linked to worse survival in various lung and heart diseases in the past. Our study proves this concept in the patients with reactive erythrocytosis often found in advanced lung and heart disease patients. Furthermore, our study gives a very strong possible explanation for this finding; that disordered overproduction of red blood cells under the stress of chronic hypoxia leads to higher RDW. The degree of hypoxia and resulting dyserythropoiesis might not be very obvious to the treating clinician and observing the trend of RDW could be very helpful in these situations. We conclude that high RDW in patients with secondary erythrocytosis should be taken very seriously and all attempts should be made to treat the underlying condition causing high hemoglobin. Disclosures No relevant conflicts of interest to declare.
Samuel Ricardo Comar - One of the best experts on this subject based on the ideXlab platform.
-
Evaluation of RDW-CV, RDW-SD, and MATH-1SD for the detection of erythrocyte Anisocytosis observed by optical microscopy
Jornal Brasileiro de Patologia e Medicina Laboratorial, 2013Co-Authors: Fernando Augusto Caporal, Samuel Ricardo ComarAbstract:INTRODUCTION AND OBJECTIVE: To evaluate the performance of red cell distribution width reported statistically as coefficient of variation (RDW-CV), standard deviation (RDW-SD), and mathematical deduction of 1 standard deviation (SD) around mean corpuscular volume (MATH-1SD) in identifying Anisocytosis in automated blood counts when compared with the manual quantification of erythrocyte Anisocytosis in peripheral blood smears. MATERIAL AND METHODS: 806 routine samples obtained from the hematology laboratory of Hospital de Clinicas da Universidade Federal do Parana (HC-UFPR) were analyzed. Performance evaluations were carried out by dividing samples into microcytic, normocytic and macrocytic mean corpuscular volume (MCV). For each MCV range, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and efficiency were calculated. In addition, the Youden index (Y) was obtained and a comparative analysis with receiver operating characteristic (ROC) curves was done to evaluate the performance of RDW-SD, RDW-CV, and MATH-1SD on different MCV ranges. RESULTS AND DISCUSSION: RDW-CV had the best sensitivity (86.8%) and efficiency (86.8%) in detecting Anisocytosis in microcytic MCV ranges. RDW-SD and MATH-1SD were more sensitive and efficient in normocytic (82.9% and 83.3%; 92.1% and 92.3%, respectively) and macrocytic (90.2% and 90.2%; 95.1% and 95.1%, respectively) MCV ranges. A ROC curve analysis indicated that RDW-CV was more efficient in detecting Anisocytosis in microcytic MCV ranges (p < 0.05 vs. RDW-SD and MATH-1SD). In normocytic and macrocytic MCV ranges, RDW-SD and MATH-1SD showed similar efficiency in detecting Anisocytosis (p < 0.05 vs. RDW-CV). CONCLUSION: RDW-SD, RDW-CV, and MATH-1SD deliver different performances in detecting blood smear Anisocytosis according to MCV values. They are parameters that complement each other and should be used together to identify erythrocyte size heterogeneity.
-
evaluation of rdw cv rdw sd and math 1sd for the detection of erythrocyte Anisocytosis observed by optical microscopy avaliacao de rdw cv rdw sd e math 1sd na deteccao da anisocitose dos eritrocitos visualizados na microscopia optica
2013Co-Authors: Fernando Augusto Caporal, Samuel Ricardo ComarAbstract:Introduction and objective: To evaluate the performance of red cell distribution width reported statistically as coefficient of variation (RDW-CV), standard deviation (RDW-SD), and mathematical deduction of 1 standard deviation (SD) around mean corpuscular volume (MATH-1SD) in identifying Anisocytosis in automated blood counts when compared with the manual quantification of erythrocyte Anisocytosis in peripheral blood smears. Material and methods: 806 routine samples obtained from the hematology laboratory of Hospital de Clinicas da Universidade Federal do Parana (HC-UFPR) were analyzed. Performance evaluations were carried out by dividing samples into microcytic, normocytic and macrocytic mean corpuscular volume (MCV). For each MCV range, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and efficiency were calculated. In addition, the Youden index (Y) was obtained and a comparative analysis with receiver operating characteristic (ROC) curves was done to evaluate the performance of RDW-SD, RDW-CV, and MATH-1SD on different MCV ranges. Results and discussion: RDW-CV had the best sensitivity (86.8%) and efficiency (86.8%) in detecting Anisocytosis in microcytic MCV ranges. RDW-SD and MATH-1SD were more sensitive and efficient in normocytic (82.9% and 83.3%; 92.1% and 92.3%, respectively) and macrocytic (90.2% and 90.2%; 95.1% and 95.1%, respectively) MCV ranges. A ROC curve analysis indicated that RDW-CV was more efficient in detecting Anisocytosis in microcytic MCV ranges (p < 0.05 vs. RDW-SD and MATH-1SD). In normocytic and macrocytic MCV ranges, RDW-SD and MATH-1SD showed similar efficiency in detecting Anisocytosis (p < 0.05 vs. RDW-CV). Conclusion: RDW-SD, RDW-CV, and MATH-1SD deliver different performances in detecting blood smear Anisocytosis according to MCV values. They are parameters that complement each other and should be used together to identify erythrocyte size heterogeneity.