What does high RDW in anemia blood routine mean?

A high RDW in anemia blood routine usually indicates uneven red blood cell size, which may be caused by diseases such as iron deficiency anemia, megaloblastic anemia, hemolytic anemia, chronic disease anemia, or myelodysplastic syndrome. RDW stands for Red Blood Cell Distribution Width, which reflects the degree of variation in red blood cell volume.

1. Iron deficiency anemia

Iron deficiency anemia is a common cause of high RDW, as insufficient iron leads to reduced hemoglobin synthesis and increased differences in red blood cell volume. The patient may experience symptoms such as fatigue, pale complexion, and dizziness. Treatment requires the supplementation of iron supplements such as ferrous succinate tablets, sustained-release ferrous sulfate tablets, and oral solution of iron dextran, while increasing the intake of iron rich foods such as animal liver and lean meat.

2. Megaloblastic anemia

Vitamin B12 or folate deficiency can lead to DNA synthesis disorders, causing abnormal increase in red blood cell volume and uneven size. Typical manifestations include glossitis, numbness in limbs, and decreased appetite. Treatment requires intramuscular injection of vitamin B12 injection or oral folic acid tablets, and daily consumption of animal organs, green leafy vegetables, etc. can be moderate. When hemolytic anemia accelerates the destruction of red blood cells, the bone marrow compensates by releasing immature red blood cells into the peripheral blood, leading to an increase in RDW. Possible jaundice, brownish urine, and splenomegaly. Immunosuppressants such as prednisone tablets and cyclosporine soft capsules should be used according to the cause, or splenectomy should be performed.

4. Chronic disease anemia

Chronic inflammation, tumors, and other diseases can interfere with iron metabolism and erythropoietin function, resulting in reduced red blood cell production and uneven volume. Control the primary disease and use recombinant human erythropoietin injection to improve anemia if necessary.

5. Myelodysplastic syndrome

Abnormal cloning of hematopoietic stem cells leads to pathological hematopoiesis, and red blood cells of different sizes and shapes may appear in peripheral blood. Commonly seen in elderly people, it manifests as refractory anemia accompanied by leukopenia or thrombocytopenia. Medications such as decitabine injection and lenalidomide capsules should be used according to the classification.

If RDW is found to be high, it should be judged comprehensively based on other blood routine indicators and clinical manifestations. It is recommended to improve serum iron metabolism, vitamin B12, folate testing, and bone marrow puncture. Pay attention to a balanced diet in daily life, avoid picky eating, and anemic patients should rest moderately and avoid vigorous exercise. Regularly check blood routine to monitor treatment effectiveness. If accompanied by persistent symptoms such as dizziness and palpitations, it is necessary to seek timely medical attention from a hematology department.