3 examples of causes of a high count Testexamples of causes ofa low countexamples of causes of a high countWhite BloodCell CountKnown as leukopeniaor damageAutoimmune conditionsSevere infections (sepsis)lymphoma or other cancer that spread to the bone marrowDiseases of immune system (e.g., HIV)Known as leukocytosisinfections most commonly bacterial or viralLeukemia, myeloproliferative disordersinflammationAllergies , AsthmaTissue death (trauma, burns, heart attack)Intense exercise or severe stress
4 examples of causes of a low count examples of causes of a high count TestFull Nameexamples of causes of a low countexamples of causes of a high countNeu, PMN, polysAbsolute neutrophil count, % neutrophilsKnown as neutropeniaSevere,over whelming infection (sepsis)Autoimmune disordersReaction to drugs, chemotherapyImmunodeficiencyBone marrow damage (e.g., chemotherapy, radiation therapy)Known as neutrophiliaAcute bacterial infectionsInflammationTissue death (necrosis) caused by trauma, heart attack, burnsleukemiaeosAbsolute eosinophilcount, % eosinophils not medically significant.Parasitic infections, asthma,allergic reaction.basoAbsolute basophil count, % basophilsnot medically significantbone marrow related conditions such as leukemia or lymphoma
5 examples of causes of a low count examples of causes of a high count TESTFull Nameexamples of causes of a low countexamples of causes of a high countmonoAbsolute monocyte count, % monocytesnot medically significant.bacterial infection, tuberculosis, malaria, monocytic leukemialymphoAbsolute Lymphocyte count, % lymphocytesKnown as lymphocytopeniaAutoimmune disorders (e.g., lupus rheumatoid arthritis)Infections (e.g., HIV, viral hepatitis , typhoid fever, influenza)Bone marrow damage (e.g., chemotherapy, radiation therapy)CorticosteroidsKnown as lymphocytosisAcute viral infections (e.g., chicken pox,cytomegalovirus (CMV), Epstein-Barr virus (EBV),herpes)Certain bacterial infections (e.g. tuberculosisLymphocytic leukemia, lymphomaStress (acute)
7 Anemia Anemia: RBC mass ed level of Hb more than 2SD of mean normal of Hb according to ageAge Hb levelNew born <13 gr/dl2-3 months < 9 FT< 7 premature6m-2y <9.52y – 6 years old <10.56 – 12 y/o <11.5>12 y/o Male < 14Female < 12Anemia
8 Mean corpuscular volume: 100 (fl) Age: 2-10 y/o MCV= Age (year) + 70 Age ≥ 10 y/o MCV < 80: MicrocytosisMCHMean corpuscular hemoglobin: 100 (Pg)More sensitive than MCVMCH hypochromia
9 Calculating the Hematocrit More commonly the Hct is calculated directly from the RBC and MCVHematocrit % = RBC (cells/liter) x MCV (liter/cell)Because the Hct is a derived value, errors in the RBC or MCV determination will lead to false resultsCalculating the Hematocrit
10 Mean Corpuscular Volume The MCV is a measure of the average volume, or size, of an RBCIt is determined by the distribution of the red blood cell histogramThe mean of the red blood cell distribution histogram is the MCVMean Corpuscular Volume
11 RBC Distribution Histogram NumberOfcellsMCV60120Cell Size (fl)
12 Use of MCV Result The MCV is important in classifying anemias Normal MCV = normocytic anemiaDecreased MCV = microcytic anemiaIncreased MCV = macrocytic anemia
14 MCHC Mean corpuscular hemoglobin concentration: 100 100It is important in diagnosis of congenital Spherocytosis (MCHC > 35):
15 PCV or Hematocrit57% Plasma1% Buffy coat – WBC42% Hct (PCV)
16 Measurement Normal Range RBC count million to 6Hemoglobin 15 g% 12 to 17Hematocrit to 50A x 3 = B x 3 = C - This is the rule of thumbCheck whether this holds good in given resultsIf not -indicates micro or macrocytosis or hypochro.
17 ‘RBC to be’ or Apprentice RBC Fragments of nuclear material RETICULOCYTE COUNT %‘RBC to be’ or Apprentice RBCFragments of nuclear materialRNA strands which stain blueNormalLess than 2%
18 The reticulocyte count Increased reticulocytes (greater than 2-3% or 100,000/mm3 total) are seen in blood loss and hemolytic processes, although up to 25% of hemolytic anemias will present with a normal reticulocyte count due to immune destruction of red cell precursors.Retic counts are most helpful if extremely low (<0.1%) or greater than 3% (100,000/mm3 total).
19 To be useful the reticulocyte count must be adjusted for the patient's hematocrit. Thus:Corrected retic. = Patients retic. x (Patients Hct/45)Reticulocyte index (RPI) = corrected retic. count/Maturation time(Maturation time = 1 for Hct=45%, 1.5 for 35%, 2 for 25%, and 2.5 for 15%.)Absolute reticulocyte count = retic x RBC number.
23 Classification by Pathophysiology Blood LossDecreased ProductionIncreased DestructionClassification by MorphologyNormocyticMicrocyticMacrocytic
24 RDW Red cell distribution width = anisocytosis RDW = 11-14.5% IDA: RDW-thalassemia minor: RDW
25 Evaluation of platelets The platelet count is the number of platelets in a person's sample of blood.Mean platelet volume (MPV) may be reported with a CBC. It is a calculation of the average size of platelets.Platelet distribution width (PDW) may also be reported with a CBC. It is a measurement of the variation of platelet size.
26 Normal Range Platelet count : 140,000 to 450,000 /cubic mm Mean platelet volume: 7.5 – 11.5 fLPlatelet distribution width: % %
27 Testexamples of causes of low resultexamples of causes of high resultPlatelet CountKnown as thrombocytopenia:Viral infection (mononucleosis,hepatitis)Rocky mountain spotted feverPlatelet autoantibodyacetaminophen, quinidine, sulfacirrhosisAutoimmune disordersSepsisLeukemia, lymphomaMyelodysplasiaChemo or radiation therapyKnow as thrombocytosis:Cancer (lung, GI,lymphoma)Rheumatoid arthritis, IBD, lupusIDAHemolytic anemiaMyeloproliferative disorder (essential thrombocythemia)
28 Examples of causes of low result TestExamples of causes of low resultExamples of causesof high resultMean Platelet VolumeIndicates averagesize of plateletsis small; olderplatelets aregenerallysmaller than younger onesand a low MPV may meanthat a condition is affecting theproduction of plateletsby the bone marrow.Indicates a high numberof larger, younger plateletsin the blood; this may bedue to the bone marrowproducing and releasingplatelets rapidly intocirculation.Platelet Distribution WidthIndicates uniformity inIndicates increasedvariation in the size of theplatelets, which may meanthat a condition is presentthat is affecting platelets