To the Editor.
—In their reply to our letter, Drs Bessman and McClure1 suggest that the high red cell distribution width (RDW) in alcoholics might be due to liver disease, since liver disease has been found to be a common cause of isolated increased RDW.2 Consequently, they state that the challenge would now be to distinguish alcohol abuse per se from the liver disease that commonly results from alcohol abuse.Our previous results3 provide a basis for considering this problem. Among the alcoholic men studied, 41% had a high RDW (>14.1%). None of the alcoholics (n=106), however, showed signs or symptoms of alcoholic liver disease. To investigate further the possibility that alcoholic liver disease explained the elevated RDW values among alcoholics, we have now reexamined results in these subjects of several tests that might indicate liver disease. No statistically significant differences in any of the tested parameters
Seppä K, Sillanaukee P. High Red Cell Distribution Width in Alcoholics: Not due to Liver Disease. JAMA. 1992;268(11):1413. doi:10.1001/jama.1992.03490110051025