Red cell distribution width as a marker of coeliac disease: a prospective study
Red cell distribution width as a marker of coeliac disease: a prospective study
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DOI：
10.1097/00042737-200202000-00012
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发表时间：
2002-02-01
影响因子：
2.1
通讯作者：
Martini, S
中科院分区：
文献类型：
--
作者：
Guidetti, CS;Scaglione, N;Martini, S
背景：由于其多变的表现，乳糜泻常常被低估。血清学检测可能有助于对高危人群进行筛查，但费用昂贵。目的前瞻性地确定一种常见的血液学检测方法，如红细胞分布宽度(RDW)，是否有助于发现未被识别的乳糜泻。方法连续353例来我科门诊吸收不良门诊就诊的成人患者，其中198例临床怀疑较强的患者被转介进行进一步的调查和肠道活检。结果198例患者中RDW增高者94例(47.4%)，正常者104例(52.5%)。十二指肠活检证实前者有80例(85.1%)有腹腔疾病，后者有69例(66.3%)。未发现RDW值与组织学评分之间的相关性。在确诊为腹部疾病的149名患者中，有80名(53.7%)的RDW总体上增加，而在活检排除该疾病的49名患者中，有14名(28.6%)RDW增加。停用面筋1年后，RDW值显著下降，即使是在顽固性粘膜损伤的患者中也是如此。结论在临床上有很强的乳糜泻嫌疑的患者，尽管血红蛋白浓度正常，但RDW升高可能是该疾病的可靠预测指标。欧洲胃肠病杂志14：177-181(C)2002，Lippincott Williams Wilkins.
Background Coeliac disease is frequently underdiagnosed because of its protean presentations. Serological tests may be helpful in screening programmes for populations at risk, but they are costly.Aim To determine prospectively whether a commonly available haematological test such as the red cell distribution width (RDW) could be of help in detecting unrecognized coeliac disease.Methods Of 353 consecutive adult patients referred to our outpatient malabsorption clinic, 198 in whom clinical suspicion was strong were referred for further investigations and intestinal biopsy. Seventy-six inflammatory bowel disease outpatients and 90 subjects admitted for diseases other than malabsorption were enrolled as the control group.Results RDW was increased in 94 (47.4%) and normal in 104 (52.5%) of 198 patients. Duodenal biopsy confirmed coeliac disease in 80 (85.1%) of the former patients and 69 (66.3%) of the latter patients. No correlation between RDW values and histological scores was found. Overall RDW increase was found in 80/149 (53.7%) patients with a definite diagnosis of coeliac disease, and in 14/49 (28.6%) patients in whom biopsy excluded the disease. A 1-year gluten withdrawal led to a significant decrease in RDW value, even in patients with obdurate mucosal impairment.Conclusions In patients in whom there is a strong clinical suspicion of coeliac disease, an elevated RDW despite normal haemoglobin concentration may be a reliable predictor of the disease. Eur J Gastroenterol Hepatol 14:177-181 (C) 2002 Lippincott Williams Wilkins.