Red cell distribution width is an inflammatory predictor marker of contrast induced nephropathy in patients undergoing percutaneous coronary intervention.

Red blood cell distribution width (RDW) is an inflammatory biomarker reported in complete blood cell (CBC) counts. High RDW defines a proinflammatory state. Contrast-induced nephropathy (CIN) is an important and common complication in percutaneous coronary intervention (PCI) treated patients. The current study was conducted to evaluate the role of RDW as a simple predictive inflammatory marker of CIN in PCI treated patients. The current prospective study enrolled 126 PCI treated patients. Laboratory investigations included CBC, liver function test, (HbA1C), lipid profile and serological tests. Serum urea and creatinine levels were obtained at baseline and 48 to 72 hours after PCI procedure, used to categorize for CIN. Diabetes mellitus, hypertension, and ischemic heart disease were present in 39 (31%), 44 (34.9%), and 23 (18.3%) patients, respectively. Of the studied patients, only 19 (15.1%) patients developed CIN. The hemoglobin level was significantly higher in the non-CIN group (13.49 ± 1.63 vs. CIN group 12.56 ± 1.62 mg/dl; p= 0.02). RDW was significantly higher among CIN group than non-CIN group (16.20 ± 2.60 vs. 13.83 ± 2.19 % (p < 0.001). Delta creatinine (% change in creatinine level after 48 hour) was significantly higher in patients with CIN (59.17 ± 28.89 vs. non-CIN 33.62 ± 9.76; p < 0.001). Predictors for CIN in patients who underwent PCI were old age high RDW high delta creatinine and amount of dye. At cut off > 14.5%, RDW had 79% sensitivity, 70% specificity and 71.3% overall accuracy at AUC of 0.76. In conclusion, RDW may be simple and immediately available inflammatory biomarker and predictor for development of CIN in patients undergoing PCI.

Severe pyoderma gangrenosum caused by myelodysplastic syndrome successfully treated with decitabine administered by a noncytotoxic regimen.

Pyoderma gangrenosum (PG) is a morbid necrotizing neutrophilic dermatoses for which current treatments are inadequate. Here, we describe the use of a novel noncytotoxic regimen of the deoxycytidine analog decitabine to treat underlying myeloid malignancy causing PG, to thereby produce safe and effective resolution of extensive PG.