Ratio of Spleen Diameter to Red Blood Cell Distribution Width A Novel Indicator for Celiac Disease
Ratio of Spleen Diameter to Red Blood Cell Distribution Width A Novel Indicator for Celiac Disease
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DOI：
10.1097/md.0000000000000726
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发表时间：
2015-04-01
期刊：
影响因子：
1.6
通讯作者：
Jinga, Mariana
中科院分区：
文献类型：
--
作者：
Balaban, Daniel Vasile;Popp, Alina;Jinga, Mariana
乳糜泻（CD）目前的诊断率相当低，因此需要开发工具来选择有可能患有乳糜泻的患者，这些患者需要进一步的检测。红细胞分布宽度（RDW）在先前的研究中被证明是CD的一个敏感预测因子，但它缺乏特异性。腹腔病人也常出现脾萎缩。我们的目的是评估脾脏直径与RDW比值是否可以作为CD的指标。我们评估了15例新诊断的CD患者，52例炎症性肠病患者和35例肠易激综合征（IBS）患者。我们评估了四组患者脾直径、RDW及其比值的差异。三分之二的乳糜泻患者RDW升高，而IBS组为9%。80%的乳糜泻患者有小脾，而溃疡性结肠炎组为21.9%，克罗恩病组为10%，肠易激综合征组为9%。脾径与RDW比值小于6预测CD的敏感性为73.3%，特异性为88.5%，AUROC为0.737。脾脏直径与RDW比值是一种简单、广泛使用的评分方法，可用于选择成年患者是否有CD的可能性。
Celiac disease (CD) is currently considerably underdiagnosed, setting the need for developing tools to select patients with probability of CD, who warrant further testing. Red blood cell distribution width (RDW) has been shown in previous studies to be a sensitive predictor for CD, but it lacks specificity. Splenic hypotrophy is also noted frequently in celiac patients.Our aim was to evaluate if spleen diameter to RDW ratio can be used as an indicator for CD.We evaluated 15 newly diagnosed CD patients, 52 patients with inflammatory bowel disease, and 35 patients with irritable bowel syndrome (IBS). We evaluated the differences in spleen diameter, RDW, and their ratio among the four groups.Two-thirds of the CD patients had elevated RDW, compared to 9% in the IBS group. A small spleen was seen in 80% of the celiacs, compared to 21.9% in the ulcerative colitis group, 10% in the Crohn disease group, and 9% in the IBS group. A spleen diameter to RDW ratio under 6 had a sensitivity of 73.3% and specificity of 88.5% in predicting CD, with an AUROC of 0.737.Spleen diameter to RDW ratio is a simple, widely available score, which can be used to select adult patients with probability of CD.