Background:
Rheumatoid arthritis is a systemic disease. The active and chronic forms of the disease can cause articular deformities. A lot of clinical and laboratory indicators were used to assess its remission or/and flare. A higher value of red cell distribution width was found in some autoimmune diseases like Rheumatoid arthritis, so it may be used to evaluate the disease activity in these patients.
Objective:
To assess the relationship between elevated RDW and the activity of Rheumatoid arthritis in Rheumatoid arhtritis patients compared with healthy control.
Methods:
A cross-sectional/case-control study was conducted on 84 rheumatoid arthritis patients,diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria, attending Damascus Hospital and 84 healthy population, matched in age and gender. Red cell distribution width was compared between the two groups, and between patient groups, according to the presence of anemia.Red cell distribution width value was also compared between the patient group itself, according to the presence of anemia, and the disease activity by using the disease activity 28 score/erythrocyte sedimentation rate. Demographic Data include:age and gender were collected, and data of the disease include: disease durations, disease activity were only collected from the patients. Laboratory tests such as complete blood count reactive protein and erythrocyte sedimentation rate were all measured.
Results:
The age of the patients was 42 ± 8 yr., while it was41.10 ±10 yr., in the control group (P= ).0.274 % were females 85.7% and were males 14.3% in patients group, while, in the control group were female78.58% and were males21.42%.
Higher red cell width value was found in patients when compared with controls, and a positive correlation between it and the activity of the disease was also found in patients.
Discussion
Red blood cell distribution width (RDW) is a test that measures the difference in the volume and size of red blood cells and is routinely used to diagnose anemia.
In our study that included 84 patients and span over a year, we found a statistical relationship between RDW measures and rheumatoid arthritis activity (DAS28-ESR)
Other studies have shown that inflammatory diseases including rheumatoid arthritis affected the hematopoiesis process, as these studies have shown that high levels of inflammatory cytokines such as IL-1, IL-6, and TNF-alpha inhibit the activity of erythropoietin by eliminating the sensitivity of erythroid progenitors towards erythropoietin thus causing immature blood cells to flow into the bloodstream resulting in high RDW.
Chronic inflammation also causes red blood cell life by increasing its degradation thus causing differences in red blood cell sizes.
Conclusions:
In patients with rheumatoid arthritis, the elevation of red cell distribution width may express the disease activity in Rheumatoid arthritis patients.