Presented by MLS Manuel Jesmi

1. +
THE DIAGNOSTIC
POINT OF FBC
Emmanuel Mawuena Akpabli, MLS

2. + “What is Full Blood Count?"
Test that evaluates blood cells
Used to detect wide range of
disorders including
anaemia,infection,leukaemia etc.
Ran on a haematology analyser
preset with coulter principle of
cell count.

3. +
………...what makes up the FBC?
 Haemoglobin(Hgb),RBC,HCT,
MCV,MCH,MCHC,RDW-
SD,RDW-CV,Micro R,Macro
R,Ret-He
PLT,PDW,MPV,PCT,IPF
WBC,Neut#,Lymph#,Mono#,Eo
s#,Baso#,Neut%,Lymph%,Mon
o%,IG#,IG%

4. + ....Haematology analyzers
3-part differential
(lymphocytes,mononuclear
cells and granulocytes)
5-part diferential
(lymphocytes,monocytes,ne
utrophils,basophils and
eosinophils

5. + ……Principles embedded in
haematology analysers
Electrical impedance (cell
size/volume and total number
of cells)
Light scatter (cell
size/volume,nuclear material
and granularity)

6. +
…Rule of three validation
A simple delta check to
validate FBC results before
establishing a diagnosis
3-times the Hb averages the
HCT
The MLS can only validate
results with an adequate
information about the patient

7. + …factors that influence FBC
results
Haemolysed,icteric and lipemic specimen falsely
increases the Hb
Sample agitation, improper mixing, prolonged
torniquette application influences platelet count.
Schistocytes falsely elevate platelet count
NRBCs falsely differentiated into TWBC
Wrong sample to EDTA volume
Reticulocytosis presenting macrocytosis

8. + …..How can all of these anomalies
resolve?
The MLS is inundated with
the requisite potentials to
comment on the
abnormalities of all blood cells
in a PBF

9. + The Diagnostic criteria of FBC
RED BLOOD CELL DISORDERS
(anemia, polycythemia)
PLATELET DISORDERS ( ITP,
Essential Thrombocythaemia)
LEUKOCYTE DISORDERS (
granulocytic leukaemia,lymphocytic
leukaemia including Hodgkins and
Non-Hodgkins Lymphoma

10. +
…Diagnosis of anaemia using FBC
 Anaemia is a reduction in the haemoglobin concentration of
the blood below normal for age and sex of the individual
 May result from nutritional deficiencies, bone marrow
failure,hemolytic crisis etc
 MALE: <13.5
 FEMALE :<12.5
 Pregnant women usually have anaemia of a dilutional
cause.

11. + …Fe deficiency anaemia
Anaemia resulting from less
availability of iron due to
insufficient supplementation or
decreased absorption.
Lab Diagnosis : Decreased MCV,
decreased
MCH/MCHC,supranormal RDW-
CV, Mentzer’s index>13 and
occasional thrombocytosis

12. + ..…Hgb defects
The diagnostic features of Beta-
Thalassemia trait is similar to that
of IDA except that beta-
Thalassemia presents with
homogenous population of RBCs.
Lab Diagnosis : Decreased MCV,
Decreased MCH/MCHC, raised
RBC, Normal RDW-CV and
Mentzer’s index<13

13. +
….Microspherocytosis
Autosomal recessive disorder
Presents with episodic hemolysis
Clinically diagnosed with
decreased MCV ,raised MCHC
and wide RDW-CV

14. + …Vaso-occlusive crisis in SCD
Occlusion of blood vessels by drepanocytes
induces inflammatory responses hence
proliferative leukocytosis is significant.
Removal of deformed RBCs by the RE
system.
Clinically diagnosed with very raised WBC,
Normal MCV and MCH/MCHC and very
wide RDW-CV. Basophilia may be present in
extreme cases

15. +
….Malaria infection
Malaria parasite releases
haemolysins that target blood
cells.
Patient presents with
pancytopenia/Bicytopenia,
occasional monocytosis,
thrombocytopenia.

16. + ….Polycythemia RV
Primary or secondary erythrocytosis.
Can be falsely diagnosed with hypovolemia
Lab Diagnosis : Normal MCV/MCH, raised
RBC (>6.5), Hgb>16.5g/dl and idiopathic
thrombocytosis.
All lab diagnosis are key to patient history
and stated clinical summary.

17. +
…..Macrocytosis
May be Megaloblastic/Normoblastic.
Caused by folate deficiency and pernicious
cause.
Caused by liver pathology,
hypothyroidism,alcoholism,hyperglycaemia
etc.
Can falsely present with reticulocytosis
Diagnosed solely with the FBC and PBF

18. +
…..Thank you