Red blood cell distribution width is a independent prognostic indicator for mortality in patients with HBV related acute-on-chronic liver failure / 南方医科大学学报

OBJECTIVE@#To establish a model for predicting the short-term prognosis of patients with HBV-related acute-onchronic liver failure (HBV-ACLF) based on red blood cell distribution width (RDW) and the model for end-stage liver disease (MELD) scores.@*METHODS@#A total of 245 patients with HBV-ACLF were retrospectively analyzed for their clinical data and results of routine hematological tests, liver function, renal function, coagulation test, HBV-DNA, and other indicators at admission. Univariate analysis and binary logistic regression analysis were used to test the short-term risk factors for death of the patients, and the MELD-RDW model was established. The accuracy of each index and the established model was verified using the ROC curve.@*RESULTS@#The surviving patients with HBV-ACLF had significantly decreased RDW (14.97 ± 1.38) and MELD score (23.54±4.35) compared with those in the patients dead within 90 days (17.05±2.92 and 28.95±5.99, respectively). Multivariate analysis indicated that RDW was a significant independent prognostic factor for mortality in patients with HBVACLF (OR=1.840, 95%CI: 1.47902.289, < 0.005). The risk assessment model was [logisticMELD-RDW]=-9.375+0.582×RDW- 0.091×ALB-0.05×PTA+0.186×MELD. The area under the ROC curve of MELD score combined with RDW was 0.878, which was higher than RDW (0.724) and MELD score (0.780) alone.@*CONCLUSIONS@#RDW is an independent prognostic indicator for mortality in patients with HBV-ACLF. Compared with MELD score, the risk assessment model based on MELD and RDW has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.

Association between red blood cell volume distribution width and osteophytes: A cross-sectional study / 中南大学学报(医学版)

To investigate the association between red blood cell volume distribution width (RDW) and osteophytes.
 Methods: This cross-sectional study was conducted in the Department of Health Examination Center of Xiangya Hospital, Central South University in Changsha, Hunan Province, China. A total of 8 334 subjects were included in this study. The severity of osteophytes was graded using the criteria of the Osteoarthritis Research Society International (OARSI). Osteophytes incident was defined as at least one side of the knee had a osteophytes grade ≥1. According to the quartiles of the RDW level, the subjects were divided into 4 groups. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) of the knee osteophytes incidence between each RDW group and the lowest level group. Tests for linear trends were conducted based on logistic regression using a median variable of RDW level in each category.
 Results: Quartile 1 (Q1), RDW≤9.78; Q2, 9.7813.10. The multivariable adjusted ORs (95%CI) of the prevalence of osteophytes were 1.38 (1.06 to 1.79) in the second percentile interval, and 1.27 (0.97 to 1.66) and 1.50 (1.15 to 1.94) in the third and fourth percentile interval, respectively. Test for linear trends suggested that there was a positive association between the RDW level and the risk of knee osteophytes incidence (P=0.019).
 Conclusion: The risk of osteophytes incidence increases with the increasing RDW levels.

Comparação entre os valores da amplitude de distribuição de diâmetro dos eritrócitos e do volume corpuscular médio com a citometria de eritrócitos em cães com leishmaniose / Comparison of amplitude values of the diameter distribution of erythrocyte volume and mean corpuscular cytometry with erythrocytes in dogs with leishmaniasis

A leishmaniose é uma zoonose de caráter endêmico que acomete diferentes espécies animal, dentre elas os cães. Como auxílio no diagnóstico e prognóstico do paciente é rotineiramente solicitado o hemograma, que é caracterizado por uma anemia do tipo normocítica e normocrômica. Os valores de volume corpuscular médio (VCM) e concentração de hemoglobina corpuscular médio (CHCM) são os padrões utilizados para a classificação da anemia, no entanto, nos últimos anos começou-se a utilizar a amplitude de distribuição de diâmetro dos eritrócitos (RDW) para diferenciar as anemias em regenerativas e arregenerativas. Este trabalho tem como objetivo comparar os valores de RDW e do VCM com a citometria eritrocitária em cães com leishmaniose. Foram colhidos sangue de 19 cães de diferentes raças e idades. As amostras sanguíneas foram processadas em equipamento automático para obtenção dos valores de VCM e RDW e posteriormente confeccionados esfregaços sanguíneos para contagem e medição de cem células eritrocitárias de cada lâmina. Para avaliar a dispersão entre os valores de hemácias utilizou-se o coeficiente linear de Pearson. Os valores de RDW mostraram-se mais sensíveis a anemia do que o VCM, quando comparados a citometria eritrocitária.(AU)

Leishmaniasis is an endemic zoonosis that affects different animals species, among them the dogs. As an aid in the diagnosis and prognosis of the patient is routinely asked the CBC, which is characterized by anemia normocytic and normochromic type. The mean corpuscular volumes (MCV) and mean corpuscular hemoglobin concentration (MCHC) are the standards used for the classification of anemia, however, in recent years begun to use the amplitude diameter distribution of red blood cells (RDW) to distinguish anemias in regenerative and arregenerativas. This study aims to compare the RDW and MCV values with the erythrocyte cytometry in dogs with leishmaniasis. blood of 19 dogs of different breeds and ages were collected. The blood samples were processed in automatic equipment to obtain the MCV and RDW and later made blood smears for counting and measuring erythrocyte hundred cells from each slide. To evaluate the dispersion between the RBC values used the linear coefficient of Pearson. The RDW were more sensitive to anemia than VCM as compared with erythrocyte cytometry.(AU)

Ancho de distribución eritrocitaria como potencial biomarcador clínico en enfermedades cardiovasculares / Red cell distribution width as a risk marker in patients with cardiovascular diseases

Red cell distribution width (RDW) is a measurement of the variation in size, as well as an index of heterogeneity of erythrocytes, which is used in combination with other hematologic parameters as an aid to the differential diagnosis of hypochromic anemia. RDW could also serve as a biomarker in the diagnosis and prognosis patients with cardiovascular diseases. However, it is unclear whether the increased heterogeneity is the cause or consequence of other pathophysiological conditions such as renal failure, malnutrition, inflammation and oxidative stress, which among other conditions are actively involved in the genesis and progression of cardiovascular diseases. The aim of this review is to show and discuss recent evidence about the role of RDW measurement as an aid in the diagnosis and prognosis of patients with such diseases. Besides being a simple, inexpensive and routinely measured parameter, it could help in the stratification of patients according to their risk in clinical practice.

Benefício do uso de recuperadores de hemácias em cirurgias cardiovasculares / Benefit from using recycling red blood cells in cardiovascular surgery

Objetivo: Avaliar se o uso de recuperadores de hemácias está indicado nos pacientes submetidos à cirurgia cardiovascular com o uso de circulação extracorpórea. Métodos: Foram estudados 77 pacientes submetidos a cirurgias cardíacas com uso de recuperadores de hemácias e circulação extracorpórea de novembro de 2010 a junho de 2012. A amostra foi subdividida em três grupos, conforme o tempo de circulação extracorpórea. No grupo A ,o tempo de circulação extracorpórea foi menor que 45, no grupo B, de 45 a 90 e, no grupo C, maior que 90 minutos. Analisou-se o volume recuperado e infundido de hemácias, a hemoglobina de pré, trans e pós-operatório, número de unidades de concentrado de hemácias transfundidas, volume globular e hemoglobina do sangue infundido. Resultados: A idade média, dos pacientes, foi de 60,44±12,09 anos, sendo 71,43% do sexo masculino. O grupo A é formado por 5,19%, o B por 81,82% e o C por 12,99% dos pacientes. O volume recuperado e infundido foi, respectivamente, de 1.360,50±511,37 ml e 339,75±87,71 ml no grupo A, 1.436,63±516,06 ml e 518,83±183,0 ml no B e 2.137,00±925,04 ml e 526,20±227,15 ml no C. Em relação às transfusões de concentrado de hemácias, no grupo A foram transfundidas 1,00±2,00 concentrado de hemácias, no B 1,27±1,85 concentrado de hemácias e no C 2,56±2,01 concentrado de hemácias. O sangue infundido tinha um volume globular de 50,97±12,06% e hemoglobina de 19,57±8,35 g/dl. Conclusão: O recuperadores de hemácias podem ser usados em pacientes submetidos à cirurgia cardiovascular com circulação extracorpórea, mas somente em cirurgias com tempo de circulação extracorpórea acima de 45 minutos o reaproveitamento de sangue ...

Objective: To show if blood salvage is indicated in all patients submitted to cardiovascular surgery with cardiopulmonary bypass. Methods: We studied 77 consecutive patients submitted to cardiac surgery with use of blood salvage and cardiopulmonary bypass from November 2010 to June 2012. The sample was divided in three groups, depending on the time of cardiopulmonary bypass. In group A, the time of cardiopulmonary bypass was smaller than 45, in group B from 45 to 90 and in group C greater than 90 minutes. We analyzed the volume of red cells recovered and infused, the pre, intra and post-operative hemoglobin, the number of packed red cells units which were transfused and hematocrit and hemoglobin blood infused. Results: The average group age was 60.44±12.09 years old, of whom 71.43% were males. The group A was formed by 5.19% of the patients, B by 81.82% and C by 12.99%. The volume of erythrocytes recovered and infused was respectively 1,360.50±511.37 ml and 339.75±87.71 ml in group A, 1,436.63±516.06 ml and 518.83±183.0 ml in B and 2,137.00±925.04 ml and 526.20±227.15 ml in C. About packed red cells transfusions, in group A 1,00±2,00 packed red cells were transfused, in B 1.27±1.85 packed red cells and in C 2.56±2.01 packed red cells. The infused blood had a hematocrit of 50.97±12.06% and hemoglobin of 19.57±8.35 g/dl. Conclusion: That blood salvage can be used in patients submitted to cardiovascular surgery with cardiopulmonary bypass. However, it is only cost-effective in surgeries in which the time of cardiopulmonary bypass is greater than 45 minutes. .

Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia.

OBJECTIVE: To study the utility of red cell distribution width (RDW) in the diagnosis of iron deficiency among children with microcytic hypochromic anemia. METHODS: 151 children (6 months-12 years) with microcytic (MCV<75 fl) anemia were classified into iron deficient (IDA) and non-iron deficient anemia (non-IDA) on the basis of serum ferritin and total iron binding capacity (TIBC). RDW values were obtained on an automated hematology analyzer. Receiver operator curves (ROC) were constructed and the utility of RDW in diagnosis of iron deficiency was studied. RESULTS: The mean RDW value was 18.37+/-2.22% in IDA group (97 children) compared to 16.55+/-1.51 % in the non-IDA group (54 children) (p<0.0001, unpaired t test). In IDA group, the mean RDW value was 16.60+/-1.78%, 17.95+/-1.91% and 20.55+/-1.32% among mild, moderate and severely anemic children (p<0.0001, ANOVA test). The corresponding values in non-IDA group were 16.03+/-1.25%, 16.76+/-1.20% and 16.77+/-2.68% respectively (p=0.269, ANOVA test). At a cut-off value of 17.4%, as obtained from the ROC curve, the sensitivity and specificity of RDW in diagnosis of IDA were 81.0% and 53.4% and a positive and negative predictive value of 63.0% and 72.2% respectively. CONCLUSION: RDW has a limited specificity for diagnosis of IDA among children with microcytic hypochromic anemia.

The effect of stimulation of toss simulated at sea on shock in severe burn rabbits / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of stimulation of toss simulated at sea on shock in severe burn rabbits.</p><p><b>METHODS</b>One hundred and thirty-two rabbits were randomly divided into normal control group (NC group, n = 6), toss group (T group, with treatment of continuous toss, n = 42), burn group (B group, with treatment of burn, n = 42), burn and toss (BT group, with treatment of continuous toss after burn, n = 42). The level of Cr, BUN, HCT and LA from blood samples in T, BT, B groups were observed at 2, 6, 8, 12, 24, 36, 48 post treatment hour (PTH). The changes in urinary volume was measured during 48 PTH. The histopathologic changes in kidney were observed at above-mentioned time points. The above indices in NC group were also observed.</p><p><b>RESULTS</b>The mean urinary volume in B group during the first and second 24 PTH was (2.59 +/- 0.23) and (2.86 +/- 0.29) mL/h, while that in BT group was (1.61 +/- 0.13) and (1.66 +/- 0.16) mL/h respectively, which were all lower than those in NC group (6.06 +/- 0.18 mL/h, P < 0.01). The levels of HCT and LA in BT group were obviously higher than those in B group at each time point. The levels of Cr and BUN in BT group at 24, 36, 48 PTH were significantly higher than those in B group. The histopathological observation showed the capillary vessels and mesenchymal cells of kidney glomerulus were congestive, epithelial cells in kidney tubules were swollen. The infiltration degree of inflammatory cells in kidney tubule, and the pathological changes of erythrocyte cast in BT group were more serious than those in B group.</p><p><b>CONCLUSION</b>The toss simulated at sea can significantly aggravate shock and the renal damages in severe burn rabbits.</p>

Valeurs erythrocytaires des jeunes footballeurs en période de compétition et de trêve au Bénin

Les valeurs erythrocytaires et le statut martial varient en fonction des periodes de la saison chez le sportif de haut niveau. Ces variations chez les pratiquants beninois n'ont jamais ete evaluees. La presente etude a pour objectif de comparer le niveau des parametres erythrocytaires entre de jeunes footballeurs et des non sportifs; en periode de competition et a la fin d'une treve de 2 semaines. Il s'agit d'une etude prospective et analytique; realisee sur 20 jeunes footballeurs de troisieme division (FB); engages dans deux competitions differentes (scolaire et civile) et 25 jeunes non sportifs (NS). Les parametres erythrocytaires ont ete mesures en simple aveugle; suite a 14 semaines d'entrai-nement et de competition (1er prelevement); puis apres une treve de 2 semaines succedant a 7 autres semaines de competition (2eme prelevement). Apres les 14 semaines d'entrainement et de competition; les parametres etudies etaient plus eleves chez les footballeurs que chez les non sportifs (p 0;05). Apres les 2 semaines de treve; les variations entre test et retest ont ete non significatives dans le groupe FB; de meme que les differences entre les groupes FB et NS (p 0;05). Les valeurs erythro- cytaires des joueurs de football etudies different de celles des non sportifs en periode de competition; mais pas en fin de trêve

Relationship between the genotype and hematologic characteristics in the fetuses with thalassemia / 中华儿科杂志

<p><b>OBJECTIVES</b>To investigate the relationship between the genotype and the hematologic characteristics in the fetuses with different types of thalassemia.</p><p><b>METHODS</b>Fetal blood samples were taken by cordocentesis, and hemograms from 572 fetuses at the gestational age of 18 to 38 weeks were examined. According to the genotypes of thalassemia, there were 117 fetuses with heterozygous alpha-thalassemia-1, and 60 with homozygous alpha-thalassemia-1. Twenty had beta-thalassemia mild, and 9 had beta-thalassemia major, respectively. The hematological parameters in these groups were compared with reference group in which 366 cases were included.</p><p><b>RESULTS</b>In alpha-thalassemia groups, hemoglobin (Hb), hematocrit (HCT), mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) significantly decreased (P < 0.001), but in heterozygous alpha-thalassemia-1, red blood cell (RBC) increased. In homozygous alpha-thalassemia-1, RBC decreased significantly (P < 0.001), but white blood cell and nucleated erythrocyte increased (P < 0.001). There were no significant differences between beta-thalassemia and reference group in most hematological parameters except for decrease of MCHC.</p><p><b>CONCLUSIONS</b>In the fetal period, the hemogram of the fetuses with alpha-thalassemia changes significantly, while it does not change in beta-thalassemia. For the couple with heterozygous alpha-thalassemia, hemogram can provide some information for prenatal screening and diagnosis for those fetuses with alpha-thalassemia, especially for homozygous, but genotype detection is necessary for confirming the diagnosis.</p>

Differential Diagnosis and Treatment of Anemia in Children / 소아과

Anemia can be defined as a reduction in blood hemoglobin concentration or red cell mass relative to age matched normal values. Clinical presentation may range from obviously pale and lethargy to an incidental finding during screening of an otherwise well appearing child. The differential diagnosis of anemia in each instance is broad with numerous possible etiologies. A careful history and physical examination as well as complete blood count, peripheral blood smear and additional laboratory tests are necessary in defining underlying cause of the anemia and guide in further treatment plans. In addition, Iron deficiency anemia and anemia of inflammation are common causes of mild to moderate anemia in children, but most pediatricians have some confusions to differentiate these two entities.

Erythrocyte volume, folate levels, and the presence of methylenetetrahydrofolate reductase polymorphism

Homozygosity for a common polymorphism in the 5,10 methylenetetrahydrofolate reductase (MTHFR) gene (C677T) has been associated to an increased risk of neural tube defects as well as derangements in folate, homocysteine, and hematological parameters. This study analyzed the relationship between folate levels, the erythrocyte volume, and the presence of homozygosity for the C677T polymorphism in a group of 126 Puerto Rican healthy women of childbearing age. Blood samples were analyzed for erythrocyte mean corpuscular volume (MCV), mean erythrocyte hemoglobin content (MCH), folate, and RBC folate. Homozygosity for the C677T mutation was determined by PCR. Thirty-two percent (32) of women used a folic acid supplement during the three months prior to sampling. Mean folate and RBC folate levels were within the normal range. Individuals homozygous for the MTHFR C677T polymorphism had no elevation of MCV (p = 0.70) or MCH (p = 0.68). Women in the lower quartile of folate levels did not show differences in their MCV or MCH. In this sample of Puerto Rican women, homozygosity for the C677T MTHFR polymorphism was not associated to elevations of MCV or MCH even in the presence of lower folate levels.

Lead ions but not other metallic ions increase resistance to hypotonic lysis in prenatal hemopoiesis red blood cells

Metals known to have toxic effects on exposed individuals (Aluminum (Al), Cadmium (Cd), Zinc (Zn) and lead (Pb)) were selected. Umbilical cord erythrocytes from normal newborns were incubated in isotonic media alone or with addition of Pb (20 microM), Cd, Zn or Al (concentration range: 20-250 microM). Red cells were then placed in media of diminishing tonicity, to measure cellular lysis and volume; the regression curves of percent lysis as a function of osmolarity were determined for each data set and the break points calculated. Resistance to lysis increased significantly in Pb treated cells whereas cells treated with the other metals did not differ from controls, even at concentrations ten times higher than that of Pb. Lead produced a reduction in cellular volume corrected by addition of quinidine (an inhibitor of potassium channels activation) to the cell suspension; on the other hand, quinidine did not modify the effect of lead on lysis sensitivity. These results suggest that the effect of lead on cell resistance to lysis might be mediated by changes in membrane structure. The other metals examined did not affect the variables studied.

Eritrocitos post trasplante renal y su tratamiento farmacológico: inhibidores de la enzima convertidora de angiotensina versus bloqueadores de los receptores de angiotensina en un caso / Treatment of post kidney transplantation erythrocytosis with angiotensin converting enzyme inhibitors or angiotensin receptor blockers: report of 1 case

A 35 years old male is presented. Eight months after receiving a renal allograft his hypertension worsened and his packed red cell volume raised to 53.7 percent. Enalapril was started and a 500 ml phlebotomy was performed. In three occasions packed red cell volumes decreased excessively and enalapril was discontinued. Finally, the drug was replaced with losartan, normalizing blood pressure values and stabilizing packed red cell volumes. This case illustrates the different reductions in packed red cell volumes induced by enalapril and losartan. These differences could have a therapeutic relevance

Indice de distribuicion de globulos rojos (RDW): su aplicacion en la caracterizacion de anemias microciticas e hipocromicas / Red cell distribution width (RDW): its use in the characterizacion of microcytic and hypochromic anemias

Con el advenimiento de los contadores hematológicos se introduce un nuevo parámetro complementario de los valores hematimétricos, el EDW (Red distribution width o indice de distribución de glóbulos rojos) que mide el grado de anisocitosis. Se estudiaron 90 pacientes con los siguientes resultados: 1) Para el grupo control constituido por voluntarios sanos (n = 50) los valores RDW fueron X+ES) 13.90 + 0.10 por ciento y VCM (X + ES) 90 + 5 fl.2) Los pacientes ferropénicos (n = 20) presentaban un VCM (X + ES) 68.60 + 1.77 fl., y RDW (X + ES) 20.20 + 1.21 por ciento.3) Los pacientes Beta-talasémicos (n = 20) VCM (X + ES) 66.45 + 1.95 fl y RDW (X + ES) 17.08 + 0.40 por ciento. Se compararon los valores obtenidos de VCM entre los pacientes ferropénicos y talasémicos entre sí y con respecto al control normal obteniéndose los siguientes resultados: control vs. ferropénico y control vs talasémicos se obtuvieron diferencias significativas con un p < 0.01. No obteniéndose diferencias significativas cuando se compararon ferropénicos vs talasémicos. Se compararon los valores obtenidos de RDW entre los pacientes ferropénicos y talasémicos entre sí y con respecto al control normal obteniéndose los siguientes resultados: control vs ferropénico y control vs talasémicos se obtuvieron diferencias significativas con un p < 0.001. También se obtuvieron diferencias significativas cuando se compararon ferropénicos vs talasémicos entre sí con un p < 0.001. Los datos estadísticos se obtuvieron aplicando el test estadístico de análisis de la varianza de una vía (ANOVA). Los resultados indican que el RDW es un indicador más sensible que el VCM en delinear el posible origen de las anemias microcíticas hipocrómicas y deberían utilizarse conjuntamente en el diagnóstico precoz de las mismas.

Three Cases of Pseudopolycythemia / 대한내과학회지

Pseudopolycythemia is a situation in which a raised concentration of hemoglobin in circulating blood, with a red cell mass within normal range, while the plasma volume may be reduced in the absence of overt fluid loss. Relative, apparent, stress, or spurious polycythemia are commonly used synonyms for the same condition. It has been emphasized the association of pseudopolycythemia with hypertension, obesity, stress, and heavy cigarette smoking, especially in middle-aged men. We experienced 3 cases of pseudopolycythemia with several risk factors. They had complained of mild exertional dyspnea, palpitation, dizziness, and paresthesia of extremities. These symptoms were successfully relieved by stress reduction, stopping of smoking, and abstaining from drinking.

Efecto de la preñez y la lactancia en el estado nutricional de los ácidos grasos esenciales en la rata / Effect of pregnancy and lactation in nutritional state of essential fatty acids in rats

To study the effect of pregnancy and lactation on red blood cell phospholipids percentual fatty acid composition of virgin, pregnant and lactating rats,,24 pregnant rats of 50ñ1 days of age were supplement with soy and 24 with fish oil during 21 days. Twelve rats of each group were sacrificed after 18 days of lactation, 24 non pregnant rats received soy oil and acted as controls of pregnant and lactating rats. Red blood cell phospholipid fatty acid composition was analized by gas chromatography. The percentage of total w-6 fatty acids of red blood cell phospholipid was 37.8ñ5.9, 32,6ñ0.6 and 38.3ñ3.5 percent in non pregnant, pregnant and lactating rats respectively (p<0.001). The figures for total w-3 fatty acids were 6.33ñ1.52, 4,31ñ0.39 and 2.7ñ0.46 respectively (p<0.001). There was no change in eicosatrienoic fatty acid percentage. Supplementation with fish oil reverted the decrease in w-6 and w-3 fatty acid percentage of pregnant and lactating rats. In conclusion, pregnancy and lactation decrease the capacity to transform precursors of essential fatty acids in long chain polyunsaturated fatty acids

Anesthetic Management of Polycythemia Vera Patient with Shoulder Joint Fracture / 대한마취과학회지

Polycythemia vera is a hematologic malignancy characterized by excessive proliferation of erythroid, myeloid and megakaryocytic elements within bone marrow, resulting in increased red cell mass, frequently leukocytosis and thrombocytosis. Patients with absolute erythrocytosis can be categorized into primary; those in whom excessive production of red cells results from a disorder intrinsic to the erythroid progenitor cells of bone marrow, or secondary; from excessive stimulation of an otherwise normal marrow by substance such as erythropoietin. Polycythemia vera is a disease process in which control prior to surgery decreases the frequency of perioperative complications. Surgery was postponed on an 61-year-old female patient found to have a hematocrit of 59%. She was phlebotomized and treated with hydroxyurea. Her hematocrit was decreased to 43%. General anesthesia was maintained with N2O-O2-enflurane after tracheal intubation. No thrombotic or bleeding problem was developed and she was discharged without complication at 14th day after operation.

Clinical usefulness of mean corpuscular volume and red cell distribution width in iron deficient blood donors

Se evaluó la eficiencia diagnóstica de la amplitud de la distribución del volumen de los eritrocitos (ADE > 14.2 por ciento) y el volumen corpuscular medio (VGM < 83.5 fL) en la detección de deficiencia de hierro en mujeres candidatas a donar sangre. Empleando la saturación de la transferrina < 17 por ciento, la prevalencia de deficiencia de hierro en 296 mujeres fue de 23 por ciento, y en 635 varones donadores de 1.1 por ciento. En el grupo total de mujeres la sensibilidad y especificidad de los índices fueron de 78 por ciento y 92 por ciento respectivamente. cuando estos parámetros diagnósticos se calcularon separando las mujeres anémicas de aguéllas no anémicas, en las primera se obtuvieron valores más altos (sensibilidad 90 por ciento y valor predictivo positivo 92 por ciento) que en las no anémicas (sensibilidad 58 por ciento y valor predictivo positivo 50 por ciento). Estos resultados confirman que hay un traslape en los valores de ADE y de VGM entre los sujetos con y sin deficiencia de hierro, y que esta sobreposición parece ser mayor entre los individuos no anémicos pero con eritropoyesis deficiente en hierro. Concluimos que los índices eritrocíticos parecerían ser pruebas útiles para identificar deficiencia de hierro en las donadoras de sangre anémicas mas no en aguéllas no anémicas