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- 1. Haemogram Interpretation By Dr M.KATASO Haematology Unit, Departmentof Internal Medicine 17/01/2023
- 2. CBC/FBC Components • RedBlood Cells (RBCs) • Hematocrit (Hct) • Hemoglobin (Hgb) • Mean Corpuscular Volume (MCV) • Mean Corpuscular Hemoglobin(MCH) • Mean Corpuscular Hemoglobin Concentration (MCHC) • Red cell distribution width (RDW) • White Blood Cells (WBCs) • Platelets • Mean Platelet Volume (MPV)
- 3. RED BLOOD CELLS(RBCs Normalrange Males: 4.20 to 5.80 m/uL Females : 3.80 to 5.20 m/uL HEMOGLOBIN Normal range Hemoglobin : M: 13.0 to 17.5 gm/ dL F: 11.5 to 15.5 gm/ dL HEMATOCRIT % of the volume of whole blood that is made up of red blood cells. (Hint: Hb x 3) Normal range M: 38 to 54 % F: 34 to 46.5 % MEAN CORPUSCULAR VOLUME(MCV) Formula HCT/RBC Normal range 80-100fL • small = microcytic • normal = normocytic • large = macrocytic
- 4. MEAN CORPUSCULAR HAEMOGLOBIN(MCH) • Measuresthe amount, or the mass, of hemoglobin present in one RBC. Formula=Hb/RBC count Normal range 27-34 pg • Decreased = hypochromic • Normal = normochromic • Increased = hyperchromic MEAN CORPUSCULAR HAEMOGLOBIN CONCENTRATION(MCHC) • Measures the proportion of each cell taken up by hemoglobin Formula=Hb/HCT Normal range 32- 36 gm/dl RED CELL DISTRIBUTION WIDTH(RDW) • Correlates with the degree of anisocytosis or variation in red blood cell width. Normal range 10-15% • Low value indicates uniformity in size of RBCs • High value indicates mixed population of small and large RBCs
- 5. Haemoglobin Elevated Primary erythrocytosis • PolycythemiaVera Secondary erythrocytosis • Chronic hypoxia(COPD, heart disease, high altitude) -Elevated erythropoietin due to malignancy Low Anemia • Microcytic • Normocytic • Macrocytic Reticulocyte Production Index(RPI) • Hyperproliferative(↑2.5) • Hypoproliferative(↓2.5) • Hypochromic • Normochromic • Hyperchromic
- 7. White Blood Cells(WBC) Normal range: 3.5 – 10.5x10⁹ /L Two types of WBC: 1) Granulocytes: – Neutrophils: 50 - 70% – Eosinophils: 1 - 5% – Basophils: up to 1% 2) Agranulocytes: - Lymphocytes: 20 - 40% – Monocytes: 1 - 6%
- 8. The Neutrophil Neutrophilia –an increase in neutrophils • Bacterial infections • Tissue destruction (burns) • Inflammation (SLE, RA, UC) • Thyrotoxicosis • Cigarette smoking • Corticosteroids • B-agonist • Leukemia • Myeloproliferative disorders • Allergies • Post splenectomy Neutropenia – a decrease in neutrophils • Decreased bone marrow production •Medications: cephalosporins,Cotrimoxazole,Chlorpromazine, dapsone, sirolimus, mycophenolate mofetil, tacrolimus, cyclosporine,carbimazole,Propyl thiouracil,Ticlopidine,phenytoin, Chemotherapy. • Immune related (ex. SLE, RA) • Post acute infection (HSV, CMV, HIV, EBV) • Zinc & Copper deficiency • Vitamin B12, folate deficiency • Autoimmune neutropenia
- 9. The Eosinophil Eosinophilia:↑eosinophil count •Parasitic infections • Allergic conditions and hypersensitivity reaction • Aspergillosis • Vasculitis • Some cancers, leukemias or lymphomas • Drug reactions • Inflammatory disorders (celiac disease, inflammatory bowel disease) Eosinopenia:↓Eosinophil count • Sepsis
- 10. The Basophils Basophilia-↑Basophils • Rareallergic reactions (hives, food allergy) • Inflammation (rheumatoid arthritis, ulcerative colitis) • Chronic myelocytic leukemia. • Polycythemia Basopenia :↓Basophils • numbers are normally low in the blood • usually not medically significant • Corticosteroid therapy, • Drug induced reactions • Acute pyogenic infections • Hyperthyroidism. • Pregnancy
- 11. The Lymphocyte Lymphocytosis –↑lymphocyte count • Viral infection( EBV, CMV, HIV, Infectious Mononucleosis) • Bacterial infections: Pertussis, Tuberculosis • Parasitic infections: Toxoplasmosis • Leukemia/Lymphoma (CLL) Lymphopenia – ↓lymphocyte count • Viral infections • Medication induced • Autoimmune disorder • Bone marrow failure • Corticosteroids
- 12. Monocytes Monocytosis-↑Monocytes • Pregnancy • Infections:TB,Syphilis,infective endocarditis,fungalinfections, Protozoan infections • Sarcoid • Collagen vascular diseases :lupus, scleroderma, rheumatoid arthritis, vasculitis • Leukemias:Monocytic or myelomonocytic leukemia (acute or chronic) Monocytopenia-↓Monocytes • Acute infection • Steroids • Leukemia • Bone marrow failure
- 13. Platelets Normal range • 150-400x 10⁹/L Thrombocytosis-↑Platelets • Splenectomy • Inflammation(Reactive) • Myeloproliferative disease (ET) • Iron deficiency anemia Thrombocytopenia-↓Platelets TTP,HUS, DIC, ITP, HIT,VITT,HELLP syndrome • Blood loss • Splenomegaly/ Hypersplenism • Medications ( antibiotics) • Viral Infections • Alcohol abuse • Bone marrow failure
- 14. References • Oxford Handbookof Clinical Haematology, 2nd Edition • Oxford Handbook of Clinical Medicine, 9th Edition
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