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Red Cell Distribution Width (RDW) measures the variability in the size of red blood cells. This parameter can help distinguish the various causes of anemia along with Mean corpuscular volume (MCV). With the addition of RDW, Mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) are no longer clinically used because of their limitations.

MCV is elevated (greater than 96) in:
– Vitamin B12 deficiency (Elevated RDW)
– Folate deficiency (Elevated RDW)
– Medications: Methotrexate, Imuran, Hydroxyurea (Normal RDW)
– Alcohol (Normal RDW)
– Liver disease (Elevated RDW)
– Multiple myeloma (Elevated RDW)
– Myelodysplastic syndrome (Elevated RDW)

MCV is normal (Between 80-96):
– Chronic disease (Elevated RDW)
– Renal failure (Elevated RDW)
– Sickle cell Anemia (Elevated RDW)
– Early Vitamin B12 and iron deficiency or mixed deficiencies (Elevated RDW)

MCV is low (less than 80) in:
– Iron deficiency (Elevated RDW)
– Toxins and drugs (Normal RDW)
– Thalassemia (Normal RDW)
– Myelodysplastic Syndrome (Elevated RDW)