Yassir Sabeeh, Malallah Akreem Ammer* and Laith Hikmetmihsun


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 subjects were included as the control group. A CD activity index >150 was considered to indicate 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 observed 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 active 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 significantly 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 active IBD.

Keywords: Red cell distribution width (RDW), C-reactive protein (CRP), Crohn’s disease (CD).

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