open access

Vol 88, No 2 (2017)
Research paper
Published online: 2017-02-28
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Elevated red blood cell distribution width is associated with intrahepatic cholestasis of pregnancy

Zehra Vural Yilmaz, Gulenay Gencosmanoglu Turkmen, Korkut Daglar, Elif Yılmaz, Ozgur Kara, Dilek Uygur
DOI: 10.5603/GP.a2017.0015
·
Pubmed: 28326516
·
Ginekol Pol 2017;88(2):75-80.

open access

Vol 88, No 2 (2017)
ORIGINAL PAPERS Obstetrics
Published online: 2017-02-28

Abstract

Objectives: Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy.

Material and methods: Ninety pregnant women with intrahepatic cholestasis of pregnancy and ninety healthy pregnant women were included in the study. Their clinical and laboratory characteristics including red blood cell distribution width, liver function tests, fasting and postprandial bile acid concentrations were analyzed.

Results: Serum red blood cell distribution width cell levels were significantly higher in pregnants with intrahepatic cholestasis of pregnancy than healthy pregnants. We also demonstrated that red blood cell distribution Width levels were higher in severe disease than mild disease and was significantly correlated with fasting and postprandial bile acid concentration in intrahepatic cholestasis of pregnancy group.

Conclusions: Our study showed that red blood cell distribution width, an easy and inexpensive marker; were associated with intrahepatic cholestasis of pregnancy and can be used as a diagnostic and prognostic marker in intrahepatic cholestasis of pregnancy.

Abstract

Objectives: Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy.

Material and methods: Ninety pregnant women with intrahepatic cholestasis of pregnancy and ninety healthy pregnant women were included in the study. Their clinical and laboratory characteristics including red blood cell distribution width, liver function tests, fasting and postprandial bile acid concentrations were analyzed.

Results: Serum red blood cell distribution width cell levels were significantly higher in pregnants with intrahepatic cholestasis of pregnancy than healthy pregnants. We also demonstrated that red blood cell distribution Width levels were higher in severe disease than mild disease and was significantly correlated with fasting and postprandial bile acid concentration in intrahepatic cholestasis of pregnancy group.

Conclusions: Our study showed that red blood cell distribution width, an easy and inexpensive marker; were associated with intrahepatic cholestasis of pregnancy and can be used as a diagnostic and prognostic marker in intrahepatic cholestasis of pregnancy.

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Keywords

red blood cell distribution width, intrahepatic cholestasis of pregnancy, severity

About this article
Title

Elevated red blood cell distribution width is associated with intrahepatic cholestasis of pregnancy

Journal

Ginekologia Polska

Issue

Vol 88, No 2 (2017)

Article type

Research paper

Pages

75-80

Published online

2017-02-28

DOI

10.5603/GP.a2017.0015

Pubmed

28326516

Bibliographic record

Ginekol Pol 2017;88(2):75-80.

Keywords

red blood cell distribution width
intrahepatic cholestasis of pregnancy
severity

Authors

Zehra Vural Yilmaz
Gulenay Gencosmanoglu Turkmen
Korkut Daglar
Elif Yılmaz
Ozgur Kara
Dilek Uygur

References (31)
  1. Geenes V, Chambers J, Khurana R, et al. Functional variants of the central bile acid sensor FXR identified in intrahepatic cholestasis of pregnancy. Gastroenterology. 2007; 133(2): 507–516.
  2. Lammert F, Marschall HU, Glantz A, et al. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol. 2000; 33(6): 1012–1021.
  3. Reyes H, Gonzalez MC, Ribalta J, et al. Prevalence of intrahepatic cholestasis of pregnancy in Chile. Ann Intern Med. 1978; 88(4): 487–493.
  4. Heinonen S, Kirkinen P. Pregnancy outcome with intrahepatic cholestasis. Obstet Gynecol. 1999; 94(2): 189–193.
  5. Allen K, Jaeschke H, Copple BL. Bile acids induce inflammatory genes in hepatocytes: a novel mechanism of inflammation during obstructive cholestasis. Am J Pathol. 2011; 178(1): 175–186.
  6. Woolbright BL, Jaeschke H. Novel insight into mechanisms of cholestatic liver injury. World J Gastroenterol. 2012; 18(36): 4985–4993.
  7. Kosters A, Karpen SJ. The role of inflammation in cholestasis: clinical and basic aspects. Semin Liver Dis. 2010; 30(2): 186–194.
  8. Romero Artaza J, Carbia CD, Ceballo MF, et al. [Red cell distribution width (RDW): its use in the characterization of microcytic and hypochromic anemias]. Medicina (B Aires). 1999; 59(1): 17–22.
  9. Montagnana M, Cervellin G, Meschi T, et al. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clin Chem Lab Med. 2011; 50: 635–641.
  10. Perlstein TS, Weuve J, Pfeffer MA, et al. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med. 2009; 169(6): 588–594.
  11. Committee opinion no 611: method for estimating due date. Obstet Gynecol. 2014; 124(4): 863–866.
  12. O'Brien KM, Allen KM, Rockwell CE, et al. IL-17A synergistically enhances bile acid-induced inflammation during obstructive cholestasis. Am J Pathol. 2013; 183(5): 1498–1507.
  13. Gujral JS, Farhood A, Bajt ML, et al. Neutrophils aggravate acute liver injury during obstructive cholestasis in bile duct-ligated mice. Hepatology. 2003; 38(2): 355–363.
  14. Kirbas A, Biberoglu E, Ersoy AO, et al. The role of interleukin-17 in intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med. 2015; 7: 1–5.
  15. Biberoglu E, Kirbas A, Daglar K, et al. The role of interleukin-17 in intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med. 2016; 29(6): 977–981.
  16. Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015; 52(2): 86–105.
  17. Hu Z, Sun Yi, Wang Q, et al. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med. 2013; 51(7): 1403–1408.
  18. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005; 352(10): 1011–1023.
  19. Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion. 2005; 20(2): 83–90.
  20. Zalawadiya SK, Veeranna V, Niraj A, et al. Red cell distribution width and risk of coronary heart disease events. Am J Cardiol. 2010; 106(7): 988–993.
  21. Patel KV, Ferrucci L, Ershler WB, et al. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med. 2009; 169(5): 515–523.
  22. Borzychowski AM, Sargent IL, Redman CWG. Inflammation and pre-eclampsia. Semin Fetal Neonatal Med. 2006; 11(5): 309–316.
  23. Romero R, Espinoza J, Gonçalves LF, et al. Inflammation in preterm and term labour and delivery. Semin Fetal Neonatal Med. 2006; 11(5): 317–326.
  24. Erdoğan S, Ozdemir O, Doğan HO, et al. Liver enzymes, mean platelet volume, and red cell distribution width in gestational diabetes. Turk J Med Sci. 2014; 44(1): 121–125.
  25. Kurt RK, Aras Z, Silfeler DB, et al. Relationship of red cell distribution width with the presence and severity of preeclampsia. Clin Appl Thromb Hemost. 2015 Mar;21(2):128-31 doi: 10 1177/1076029613490827 Epub. ; 2013: May.
  26. Abdullahi H, Osman A, Rayis DA, et al. Red blood cell distribution width is not correlated with preeclampsia among pregnant Sudanese women. Diagn Pathol. 2014; 9: 29.
  27. Arrese M, Reyes H. Intrahepatic cholestasis of pregnancy: a past and present riddle. Ann Hepatol. 2006; 5(3): 202–205.
  28. Rook M, Vargas J, Caughey A, et al. Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort. PLoS One. 2012; 7(3): e28343.
  29. Lo JO, Shaffer BL, Allen AJ, et al. Intrahepatic cholestasis of pregnancy and timing of delivery. J Matern Fetal Neonatal Med. 2015; 28(18): 2254–2258.
  30. Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology. 2004; 40(2): 467–474.
  31. Geenes V, Chappell LC, Seed PT, et al. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study. Hepatology. 2014; 59(4): 1482–1491.

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