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Red Cell Distribution Width (RDW)

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  • Red Cell Distribution Width (RDW)

    The RDW is an index of the variation in cell volume within the red cell population.
    It is a parameter provided by both impedance and flow cytometric analyzers.
    Mathematically, it is the coefficient of variation, i.e.,


    RDW = (Standard deviation of red cell volume ÷ mean cell volume) x 100

    Red cell populations with higher than normal RDW are termed heterogenous; those with normal RDW are homogeneous.

    For example, increased numbers of reticulocytes will cause an increased RDW.

    In some instances, the RDW is the first test result to increase with changes in red cell population sizes.

    For example, in early iron deficiency, there are only low numbers of microcytic red blood cells.
    This will increase the standard deviation and the RDW, but the mean cell volume is unchanged
    because there are insufficient numbers of microcytic cells to change the mean volume.


    The sample on the right has a dual (bimodal) red cell population.
    The larger (rightmost) peak represents reticulocytes in the blood.
    The very small second peak in the normal sample
    represents "doublets" (red cells passing the aperture in pairs).

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