Complete blood count and its importance in dentistry
“Abasic screening test that evaluates the cells that circulate in blood.”A complete blood count (CBC), also known as full blood count (FBC) or full blood exam (FBE) or blood panel.
Screen for a wide rangeof conditions and Help diagnose various conditions, such as anemia ,infection,diseases inflammation, bleeding disorder or leukemia etc Monitor treatment that is known toMonitor the condition and/or affect blood cells, such aseffectiveness of treatment after chemotherapy or radiation therapya diagnosis is established
• A CBC is a panel of tests that evaluates the three types of cells that circulate in the blood and includes the following:Evaluation of white blood cellsEvaluation of red blood cellsEvaluation of platelets
• White blood cell (WBC) count is a count of the total number of white blood cells in a persons sample of blood. All the white cell types are given as a percentage and as an absolute number per litre.• White blood cell differential may or may not be included as part of the panel of tests. It identifies and counts the number of the various types of white blood cells present. The five types include neutrophils, lymphocytes,mon ocytes, eosinophils, and basophils.
Full examples of examples ofTest causes of a low causes of a Name count high countWBC White Known as leukopenia Known as Blood or damage leukocytosis Cell Count •infections most •Autoimmune conditions commonly •Severe infections bacterial or viral (sepsis) •Leukemia, •lymphoma or other myeloproliferativ cancer that spread to e disorders the bone marrow •inflammation •Diseases of immune •Allergies , system (e.g., HIV) Asthma •Tissue death (trauma, burns, heart attack) •Intense exercise or severe stress
Test Full Name examples of causes of examples of causes a low count of a high countNeu, Absolute neutro Known as neutropenia Known asPMN, phil count, % •Severe,over whelming neutrophiliapolys neutrophils infection (sepsis) •Acute bacterial •Autoimmune infections disorders •Inflammation •Reaction to drugs, •Tissue death chemotherapy (necrosis) caused •Immunodeficiency by trauma, heart •Bone marrow damage attack, burns (e.g., chemotherapy, •leukemia radiation therapy)eos Absolute eosino not medically Parasitic phil significant. infections, count, % asthma,allergic eosinophils reaction.baso Absolute basoph not medically bone marrow il count, % significant related conditions basophils such as leukemia or lymphoma
TEST Full Name examples of examples of causes of a low causes of a high count countmono Absolute monocy not medically bacterial infection, te significant. tuberculosis, count, % malaria, monocytic monocytes leukemialympho Absolute Known as Known as Lymphocyte lymphocytopenia lymphocytosis count, % •Autoimmune •Acute viral lymphocytes disorders infections (e.g., lupus rheumat (e.g., chicken oid arthritis) pox,cytomegaloviru •Infections (e.g., s (CMV), Epstein- HIV, viral hepatitis , Barr virus typhoid (EBV),herpes) fever, influenza) •Certain bacterial •Bone marrow infections damage (e.g., (e.g. tuberculosis chemotherapy, •Lymphocytic radiation therapy) leukemia, •Corticosteroids lymphoma •Stress (acute)
Red blood cell (RBC) count is a count of the actual number of red blood cells in a persons sample of blood. Hemoglobin measures the amount of the oxygen- carrying protein in the blood. Hematocrit measures the percentage of a persons blood that consists of red blood cells. Red blood cell indices are calculations that provide information on the physical characteristics of the RBCs: • (RDW), which may be included in a CBC, is a calculation of the variation in the size of RBCs. • Mean corpuscular volume (MCV) is a measurement of the average size of RBCs. • Mean corpuscular hemoglobin is a calculation of the average amount of oxygen- carrying hemoglobin inside a red blood cell. • Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average percentage of hemoglobin inside a red cell. reticulocyte count which is a measurement of the absolute count or percentage of young red blood cells in blood.
examples of causes of examples of causes ofTest Full Name low result high resultRBC Red Blood Known as anemia Known as polycythemia Cell Count •Acute or chronic • Dehydration bleeding •Pulmonary disease •RBC destruction •Kidney or other tumor (e.g.hemolytic that produces excess anemia,etc.) erythropoietin •Nutritional deficiency •Smoking (e.g., iron deficiency, •Genetic causes (altered vitamin B12 or folate oxygen sensing, deficiency) abnormality in •Bone marrow disorders hemoglobin oxygen or damage release) •Chronic inflammatory disease •Kidney failure Usually mirrors RBC Usually mirrors RBCHb Hemoglobin results, provides added results information Usually mirrors RBC Usually mirrors RBCHct Hematocrit results; most common results cause is dehydration
examples of causes ofTest examples of causes of Full Name low result high result Indicates RBCs are Indicates RBCs are smaller than normal larger than normal Mean (microcytic); caused (macrocytic), forMCV Corpuscul by iron deficiency example in anemia ar Volume anemia or thalassemia, caused by folate or vit for example. B12 deficiency Mean Mirrors MCV results; Corpuscul Mirrors MCV results; macrocytic RBCs areMCH ar small red cells would large so tend to have a Hemoglobi have a lower value. higher MCH. n Increased MCHC values (hyperchromia) are seen in conditions Mean May be low when MCV is where the hemoglobin Corpuscul low; decreased MCHC is more concentrated ar values (hypochromia) inside the red cells,MCHC Hemoglobi are seen in conditions such as autoimmune n such as iron deficiency hemolytic anemia, in Concentra anemia and burn patients, and tion thalassemia. hereditary spherocytosis, a rare congenital disorder.
Test Full Examples of causes of Examples of causes of Name low result high result Indicates mixed population of small and large RBCs; immature RBCs tend to be larger. For example, in iron RBC Low value indicates deficiency anemia or DistribRDW uniformity in size of pernicious anemia, ution RBCs there is high variation Width (anisocytosis) in RBC size (along with variation in shape – poikilocytosis), causing an increase in the RDW. In the setting of anemia, In the setting of anemia, a high reticulocyte a low reticulocyte count Reticul count generally indicates a condition is ocytes indicates peripheral affecting the productionReticuloc (absol cause, such as bleeding of red blood cells, suchyte count ute or hemolysis, or as bone marrow count response to treatment disorder or damage, or a or %) (e.g., iron nutritional deficiency supplementation for (iron, B12 or folate) iron deficiency anemia)
The platelet count is the number of platelets in a persons 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.
• Platelet count : 140,000 to 450,000 /cubic mm• Mean platelet volume: 7.5 – 11.5 fL• Platelet distribution width: 10% - 17.9%
Full examples of causes of examples of causes ofTest Name low result high resultplt Platelet Known as Know as Count thrombocytopenia: thrombocytosis: •Viral infection •Cancer (lung, (mononucleosis,hepatiti gastrointestinal,lymp s) homa) •Rocky mountain spotted •Rheumatoid arthritis, fever inflammatory bowel •Platelet autoantibody disease, lupus •Drugs (acetaminophen, •Iron deficiency quinidine, sulfa drugs) anemia •cirrhosis •Hemolytic anemia •Autoimmune disorders •Myeloproliferative •Sepsis disorder (e.g., •Leukemia, lymphoma essential •Myelodysplasia thrombocythemia) •Chemo or radiation therapy
Test Full Examples of causes Examples of causes of high Name of low result result Indicates average size of platelets is small; older platelets are Indicates a high number generally of larger, younger platelets smaller than Mean in the blood; this may be younger onesMPV Platelet due to the bone marrow and a low MPV may Volume producing and releasing mean platelets rapidly into that a condition is circulation. affecting the production of platelets by the bone marrow. Indicates uniformity Indicates increased Platelet in variation in the size of the Distrib size of plateletsPDW platelets, which may mean ution that a condition is present Width that is affecting platelets
Reviewing clinical laboratory test results about a patients condition can provide valuable information forDiagnosis and management of orofacial conditionsGuidance on assessing the patients ability to tolerate the proposed dental treatmentA prognosis based on a particular treatment
EVALUATION OF WBC• when a patient is being treated with a medication that suppresses WBC production (such as antineoplastic agents), the patient is at a greater risk for postoperative infection, and dental treatment should be deferred until the WBC result is back to normal.• For invasive dental treatment, perioperative antibiotics are indicated in patients with ANC less than 1,000 cells/mm3 in order to minimize the risk of infection. When the ANC falls below 500 cells/mm3, intravenous antimicrobial therapy may be necessary to prevent sepsis resulting from invasive dental treatment.
EVALUATION OF RBC• Patients with polycythemia may experience orthopnea in the dental chair, dizziness, headache, red facial coloring, and dyspnea.• Hgb and Hct are necessary parts of the assessment for anemias and in patients with burning mouth disorders and aphthous stomatitis.• Differ routine dental treatment in Patient with severe anemia
EVALUATION OF PLATELETS• Bleeding disorders or bone marrow diseases, such healthcare provider to determine as leukemia, require the dental the number of platelets present and/or their ability to function correctly prior to invasive surgery.• Minor dentistry: counts should be greater than 50,000/cubicmm