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1. Complete blood count
Poojalakshmi
111801089

2. Complete blood count
• CBC is a test that counts the
cells that make up your
blood
i. Red blood cells
ii. White blood cells
iii. Platelets
• Uses:
i. Detect any abnormalities in
the blood parameters
ii. Screening and Diagnosis of
various disorders
iii. Monitor the progress of
treatment

3. Components of CBC
• RBC
• Hemoglobin
• Hematocrit
• MCV
• MCH
• MCHC
• RDW
• Reticulocyte count
• WBC
• Neutrophils
• Lymphocytes
• Eosinophils
• Monocytes
• Basophils
• Platelets

5. Red blood cells
• Measures the number of red blood cells
• Decreased –anaemia
• Increased – polycythemia
• Normal Value:
• Male – 4.5 to 6.5 x10^12/l
• Females – 3.8-5.8x10^12/l

6. LOW RBC COUNT
• Acute or chronic bleeding
• RBC destruction (Hemolytic
anemia)
• Bone marrow disorders or
damage
• Chronic kidney disease
High RBC count
• Living at high altitude
• Polycythemia vera
• Tumor that produces more
erythropoietin ( RCC,
hepatoma)

7. Haemoglobin
• Measures the concentration of haemoglobin in RBC
• Hb- it is a protein molecule that carries oxygen in the red blood cells
• Normal values :
• Male :13-18 g/dl
• Female: 11.5-16.5 g/dl

8. Haematocrit (Hct)
• Percentage of the volume of whole blood that’s made up of red blood
cells.
• Also known as Packed cell volume (PCV)
• REFERENCE RANGE
• Men : 40– 54%
• Female : 37-47%
• HCT = length of column of RBC * 100
• total length of blood component

10. Red blood cell indices
• MCV – denoted the size of RBCs
• MCH- mass of haemoglobin per RBC
• MCHC- concentration of haemoglobin in RBC

11. Mean corpuscular volume
• Corresponds to the size of red blood cells
• Normal value: 78-98 fl
• MCV(fL) = HCT
• RBC

12. LOW MCV(Microcytic)
• Iron deficiency anemia
• Thalassemias
• Lead poisoning
• Pyridoxine deficiency
• Anemia of chronic disease
HIGH MCV(Macrocytic)
• Vit B12 deficiency anemia
• Folate deficiency
• Intestinal malabsorption
syndrome
• Alcohol

13. Mean corpuscular haemoglobin
• Measures the mass of haemoglobin present in one RBC
• The weight of Hb is obtained dividing Hb by total blood count
• Reported in picogram.
• Reference range: 27-32 pg
• MCH = Hb
RBC

14. Mean corpuscular haemoglobin
concentration
• Measures the proportion of each cell taken up by haemoglobin
• It is the ratio of hemoglobin mass to the volume of red cells
• Haemoglobin divided by hematocrit and multiplied by 100
• Reference range : 33.4 – 35.5 g/dL
• MCHC(g/dL) : Hb(g/dl)
HCT
• MCHC is increased in spherocytosis .
• MCHC is decreased in iron deficiency anaemia and thalassemia .

15. Red cell distribution width (RDW)
• It measures variation in RBC size or RBC volume it is used in
conjunction with the MCV to determine if anaemia is due to mixed
cause as a single cause
• Reference range : 11.6 to 14.6 % adults
• Elevated RDW is seen in anisocytosis and poikilocytosis

16. • Normal RDW and normal MCV : acute blood loss, anaemia of renal
disease
•
• Normal RDW and low MCV: Beta thalassaemia trait
• Normal RDW and High MCV: aplastic anaemia

17. • High RDW and normal MCV :
• Early iron deficiency , vit b12 deficiency or folate deficiency
• Sickle cell disease
• Chronic liver disease
• High RDW and low MCV :
• Iron deficiency
• Sickle cell anaemia and beta thalassemia
• High RDW and High MCV :
• Vitamin b12 deficiency
• Myelodysplastic syndrome

18. Reticulocyte count
• It is the concentration of immature RBC in a volume of blood
• Reference range : 0.5% - 2.5% (25-85x 10^9/L)
• Reticulocyte count reflects RBC production

19. • High reticulocyte count:
• Haemolytic anaemia
• Following therapy in iron deficiency, B12 deficiency, folic acid
deficiency anaemia
• Low reticulocyte count
• Aplastic anaemia
• Pure red cell aphasia
• Aplastic crisis in parvo virus ( hereditary spherocytosis and sickle cell
disease )

20. WHITE BLOOD CELLS
• It is used to maintain a healthy state and to fight the infections or
other causes of injury
• White blood cell components
• Neutrophils
• Eosinophils
• Basophils
• Monocytes
• Lymphocytes

21. White blood cell count
• Reference range : 4-11 x 10^9/L
• Leucopenia : decreased WBC count
• Leucocytosis : increase WBC count

22. Low WBC count or leukopenia
• Radiation
• Cytotoxic drugs
• Hyper splenism
• Typhoid and paratyphoids
• Aplastic anaemia
• Megaloblastic anaemia
High WBC count or leukocytosis
• Bacterial, viral infections
• Leukemoid reaction
• Leukaemia
• Pregnancy
• Exercise

23. Differential leukocytic count
• Neutrophils
• Comprises 60-70% of the WBCs
• Their main function is defence against infections
• Reference range 2.0-7.5x10^9/l

24. LOW COUNT
Neutropenia
HIGH COUNT
Neutrophilia
Post chemotherapy , irradiation Acute bacterial infections
Autoimmune diseases like SLE
Acute Inflammation like acute appendicitis.
Protozoan infections like malaria , viral
infections like EBV, HIV .
Acute stress states like post surgery , post
haemorrhage
Drugs like chloramphenicol, cotrimoxizole ,
phenytoin , valproic acid
Corticosteroids

25. Differential leukocytic count
• Lymphocyte count
• To assess the lymphoid system , comprises 25-40% of wbc
• T cells (cell-mediated immunity), B cells (humoral
immunity), NK cells
• Reference range 1.5-4.0x10^9/l

26. LOW COUNT
Lymphocytopenia
HIGH COUNT
Lymphocytosis
Autoimmune disorders like rheumatoid arthritis,
SLE
Acute viral infections(chickenpox , CMV, EBV,
Herpes, rubella)
Corticosteroid, cytotoxic drugs, military TB . Chronic bacterial infections(pertussis, TB)
Bone marrow damage(chemotherapy ,radiation
therapy )
Chronic lymphocytic leukaemia, non Hodgkin’s
lymphoma

27. Differential leukocytic count
• Monocyte count
• They are phagocytic cells that circulate in blood , they
migrate to tissues and mature into macrophages
• They comprises about 4-5% of wbc
• Reference range 200-800/mcL

28. LOW COUNT
Monocytopenia
HIGH COUNT
monocytosis
Aplastic anaemia Chronic infections like TB
Malaria , bacterial endocarditis, syphilis.
corticosteroids Chronic inflammatory diseases like ulcerative
colitis , crohns diseases, SLE .
Hairy cell leukemia Hodgkins disease

29. Differential leukocytic count
• Eosinophil count
• Most often indicated in parasitic infection, allergic reaction
• Comprise 1-4%
• Reference range 0.04-0.4x10^9/l
LOW COUNT
Eosinopenia
HIGH COUNT
Eosinophilia
Very rare Allergic states like asthma , urticaria, hay fever
Primary elevation of adrenal corticosteroids
and epinephrine
Parasitic infections like hook worm , round
worm infestation
Acute inflammation or stress Hyper eosinophilic syndrome, tropical
eosinophilia,

30. Differential leukocytic count
• Basophil count
• These involve mainly in immediate hypersensitivity reactions, release histamine and other
cytokines
• They comprise 0.3- 1% of wbc
• Reference range 0.01-0.1x10^9/l
LOW COUNT
Basopenia
HIGH COUNT
Basophilia
Very rare Food allergies
Chemotherapy, radiation Inflammations(rheumatoid arthritis,
ulcerative colitis)
Stress, prolonged corticosteroid therapy Ig E hypersensitivity

31. Platelet count
• Platelets play an important role in coagulation and thrombosis
• Low platelet count – increased risk of bleeding and bruising
• High platelet count – excessive clotting
• Reference range – 150-350x10^9/l
• Increased Platelet count = thrombocytopenia
• Decreased platelet count = thrombocytosis

32. Thrombocytopenia Thrombocytosis
Immunological- SLE , immune thrombocytopenic
purpura
Rheumatoid arthritis, IBD
Drugs (acetaminophen, quinidine) Iron deficiency anemia
Sequestration- Splenomegaly Hemolytic anemia
Decreased production- Leukemia, aplastic anaemia
.
Post surgery

33. Thank you !