Published online Jul 21, 2017. doi: 10.3748/wjg.v23.i27.4879
Peer-review started: February 28, 2017
First decision: April 26, 2017
Revised: May 2, 2017
Accepted: June 9, 2017
Article in press: June 12, 2017
Published online: July 21, 2017
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.
Core tip: Mounting evidences show that red blood cell distribution width can be used as a prognostic marker in gastrointestinal disorders. A number of retrospective studies have been published about the use of this index of anisocytosis in prognostication of gastrointestinal disorders, especially inflammatory bowel disease and viral hepatitis among others. However, only a few have included confounding factors which could affect red blood cell distribution width. Our objective is to consolidate the current literature to better understand the use and further investigate the significance of red blood cell distribution width in gastrointestinal disorders.