Context: The initial classification of anemia can be improved substantially by including RDW and histograms of the red cell volume as these variable become part of the routine blood counts. Aims: To evaluate the effectiveness of the RDW parameter in the diagnosis of the erythrocyte disorders. Settings and Design: A hospital based cross sectional diagnostic evaluation study, Department of Pathology, Lt. BRKM Government Medical College. Methods and Material: 250 randomly selected cases of anemia were studied. All patients having hemoglobin value of less than 12.5 gm were included in the present study. Initially all patients were screened by automated cell counter. Those with hemoglobin of less than 12.5 gm were included in the present study. A possible pathophysiologic entity was assigned. Now the peripheral smear was screened and a specific etiology (category or cases) was assigned. Statistical Analysis: Chi square test was used wherever appropriate. P value of less than 0.05 was taken as statistically significant. Results: Decreased MCV and mild increase in RDW was seen in thalassemia trait. Serum iron was found to be normal in IDA patients. Low MCV and high RDW was found to be a good predictor of IDA. Single parameter of high MCV was found to be of poor diagnostic value in B12 deficiency anemia. Very high RDW was a consistent feature of sickle cell disease. Fairly deciding heterogeneity was observed with decrease to normal MCV in cases of various types of hemolytic anemia. Conclusion: RDW is a fairly sensitive and specific diagnostic approach and can eliminate unnecessary expensive and invasive investigations.

Keywords: Sickle Cell Disease; Iron Deficiency Anemia; Beta Thalassemia; MCV; RDW; MCH.