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Mixed-deficiency (iron + B 12 or folate) anemia usually presents with high RDW and variable MCV. Recent hemorrhages typically present with high RDW and normal MCV. A false high RDW reading can occur if EDTA anticoagulated blood is used instead of citrated blood. See Pseudothrombocytopenia. By severity, elevated RDW can be classified as follows:
Anisocytosis is a medical term meaning that a patient's red blood cells are of unequal size. This is commonly found in anemia and other blood conditions. False diagnostic flagging may be triggered on a complete blood count by an elevated WBC count, agglutinated RBCs, RBC fragments, giant platelets or platelet clumps due to anisocytosis.
A low RDW has no clinical significance, but an elevated RDW represents increased variation in red blood cell size, a condition known as anisocytosis. [118] Anisocytosis is common in nutritional anemias such as iron deficiency anemia and anemia due to vitamin B12 or folate deficiency, while people with thalassemia may have a normal RDW. [118]
A hallmark of polycythemia vera is an elevated hematocrit, with Hct > 55% seen in 83% of cases. [20] A somatic (non-hereditary) mutation (V617F) in the JAK2 gene, also present in other myeloproliferative disorders, is found in 95% of cases. [21]
Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs). Macrocytes (larger than normal RBCs) are present. Ovalocytes (oval-shaped RBCs) are present. Howell-Jolly bodies (chromosomal remnant) also present. Blood chemistries will also show: An increased lactic acid dehydrogenase (LDH) level. The isozyme is LDH ...
The flat surface of the discoid RBCs gives them a large surface area to make contact with and stick to each other; thus forming a rouleau. They occur when the plasma protein concentration is high, and, because of them, the ESR (erythrocyte sedimentation rate) is also increased. This is a nonspecific indicator of the presence of disease.
The mean cell volume is commonly decreased (i.e., a microcytic anemia), but it may also be normal or even high. The RDW is increased with the red blood cell histogram shifted to the left. Leukocytes and platelets are normal. Bone marrow shows erythroid hyperplasia with a maturation arrest.In excess of 40% of the developing erythrocytes are ...
An increased red cell distribution width (anisocytosis) also suggests megaloblastosis and is commonly seen in Vitamin B 12 deficiency and folate deficiency. [2] This type of anemia is caused by impaired DNA synthesis and repair, often from deficient thymidine production. [2] Thiamine responsive megaloblastic anemia syndrome also causes ...