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Abstract

RED CELL DISTRIBUTION WIDTH: A USEFUL MARKER OF DISEASE ACTIVITY IN INFLAMMATORY BOWEL DISEASE

Yassir Sabeeh, Dr. Malallah Akreem Ammer* and Laith Hikmetmihsun

ABSTRACT

Background and Objective: Studies concerning red cell distribution width (RDW) for use in the assessment of inflammatory bowel disease (IBD) activity are limited. We investigated whether RDW is a useful clinical marker of active disease in patients with IBD. Methods: In total, (66) patients with ulcerative colitis (UC) and (28) patients with Crohn’s disease (CD) were enrolled in the study group, and (40) age- and-sex-matched healthy sub-jects were included as the control group. A CD activity index >150 was considered to indi-cate active disease, while moderate and severe disease based on the Truelove-Witts criteria were considered to indicate active UC. All IBD patients had a total colonoscopy assessment and endoscopic findings were recorded according accepted endoscopic severity scores for UC and CD. In addition Red Cell Distribution Width (RDW), hemoglobin (HB), serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum albumin and platelet counts were measured. Results: Among the 94 patients included in the study, 48(51.1%) patients were classified to be in remission and 46(48.9%) patients were in relapse. Significant increases in RDW, CRP, ESR and platelet count with concomitant decrease in HB and serum albumin levels were ob-served in all groups compared to the control group (p < 0.0001 for all correlations except for albumin p=0.004). We also observed a significant difference in the above markers in the ac- ive disease periods of both CD and UC groups compared to the remission state (p<0.0001 for all except for CRP in UC p<0.001 and Albumin in CD p=0.96). RDW values were also sig- ificantly correlated with endoscopic severity assessed by accepted endoscopic scores of UC and CD (p < 0.0001 for both). This therefore demonstrates that there is a strong correlation between ESR, CRP, HB, Albumin, Platelets and RDW values in IBD patients. Conclusions: RDW was elevated in IBD in comparison with healthy controls and increased markedly in active disease. RDW may be a sensitive and specific marker for determining ac-tive IBD.

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