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Red blood cells have an average volume of 80–100 femtoliters, but individual cell volumes vary even in healthy blood. [1] Certain disorders, however, cause a significantly increased variation in cell size. Higher RDW values indicate greater variation in size. Normal reference range of RDW-CV in human red blood cells is 11.5–15.4%.
Conditions that cause rouleaux formation include infections, multiple myeloma, Waldenström's macroglobulinemia, inflammatory and connective tissue disorders, and cancers. It also occurs in diabetes mellitus and is one of the causative factors for microvascular occlusion in diabetic retinopathy.
Microscopic viewing of the red blood cells will reveal marked unequal cell size and abnormal cell shape. Basophilic stippling is marked and target cells are common. The mean cell volume is commonly decreased (i.e., a microcytic anemia), but it may also be normal or even high. The RDW is increased with the red blood cell histogram shifted to the ...
Diagnosis is typically based on blood tests that find high numbers of mature lymphocytes and smudge cells. [5] This is an example of how a smudge cell looks on a peripheral blood smear, which is a common finding in patients with chronic lymphocytic leukemia (CLL).
Blood tests to eliminate other common causes of cytopenias such as lupus, hepatitis, B 12, folate, or other vitamin deficiencies, kidney failure or heart failure, HIV, hemolytic anemia, monoclonal gammopathy: Age-appropriate cancer screening should be considered for all anemic patients.
Red blood cell distribution width (RDW or RDW-CV or RCDW and RDW-SD) is a measure of the range of variation of red blood cell (RBC) volume, yielding clues about morphology. [ citation needed ] Erythropoietic precursor indices