Abstract
We have read the article “Red cell distribution width identifies cerebral venous sinus thrombosis in patients with headache” by Demir et al. 1 They aimed to investigate the validity of red cell distribution width (RDW) in cerebral venous sinus thrombosis (CVST) diagnosis in patients presenting with headache. They concluded that RDW is a highly valuable marker in the diagnosis of CVST in patients presenting with headache. This study gives important information on this clinically relevant condition. The ready availability of this parameter at no additional cost may encourage its wider use in clinical practice in the future. Thanks to the authors for their contribution.
However, we think that some points should be discussed. Newly inflammatory markers are considered a major risk factor predisposing to cardiovascular morbidity and mortality. 2 Recently, elevated RDW has been identified and proposed to be of importance.
Red cell distribution width is a measure of the variability in the size of circulating red blood cells and is a part of the complete blood count panel. Red cell distribution width is expressed as the coefficient of variation in the erythrocyte volume. Some studies have reported that elevated RDW levels are associated with poor prognosis in the setting of stable angina, acute coronary syndrome, coronary bypass surgery, heart failure, stroke, peripheral arterial disease, older age, and in the patients with or without coronary artery disease. 3 Red cell distribution width is associated with iron deficiency, inflammation, uraemia, transfusion, ethnicity, neurohumoral activation, thyroid disease, hepatic dysfunction, bone marrow dysfunction, inflammatory diseases, chronic or acute systemic inflammation, 4 and use of some medications. 5 Finally, because the present study has designed as a retrospective cross-sectional study, the authors cannot define how much time elapsed from time of bloodletting to time of RDW determination. 6
In conclusion, we strongly believe that those findings obtained from the current study will lead to further studies examining the relationship between RDW and CVST. However, one should keep in mind that RDW itself may not give exact information to clinicians about the inflammatory status of patients with CVST. So, from that point of view, we think that it should be evaluated accompanied with other serum inflammatory markers.