The role of red cell distribution width as a marker in inflammatory bowel disease

Aim: To determine whether red cell distribution width could be used for the assessment of disease activity in patients with inflammatory bowel disease. Materials and methods: A total of 165 patients with inflammatory bowel disease (105 ulcerative colitis; 60 Crohn's disease) and 43 healthy blood donors were included in this retrospective study in a tertiary care setting. The medical records of the patients were reviewed to note clinical activity indices, red cell distribution width, serum C reactive protein, erythrocyte sedimentation rates, leukocyte, and platelet counts. Results: Red cell distribution width, serum C reactive protein, erythrocyte sedimentation rate, platelet count, and the proportion of individuals with increased red cell distribution width were all significantly elevated in the patients compared to the controls (P < 0.05). Red cell distribution width and the proportion of patients having elevated red cell distribution width were higher in patients with Crohn's disease compared with ulcerative colitis (P < 0.05). Red cell distribution width was significantly correlated with erythrocyte sedimentation rate, endoscopic activity index (in ulcerative colitis), and platelet count (P < 0.05). For a red cell distribution width cut-off of 14.45 sensitivity for differentiation of Crohn's disease from ulcerative colitis was 70% and specificity was 56%. Conclusion: Red cell distribution width, as a cost-effective tool, could be an additional parameter to assess disease activity in inflammatory bowel disease and an adjunctive marker in the differentiation between ulcerative colitis and Crohn's disease.