This document provides information about components of a complete blood count (CBC) test and their normal ranges. It discusses red blood cells, white blood cells, platelets, hematocrit, hemoglobin and other components. Abnormal results are explained, such as anemia, leukocytosis, thrombocytopenia. Causes of abnormalities in each component are outlined, including infections, deficiencies, diseases. Interpretation of CBC can provide clues to underlying bone marrow or blood disorders.

1. بسم الله الرحمن الرحیم
In the hgd name ال
of
ALLAH

2. DIAGRAMATIC REPRESENTATION OF BONE MARROW PLURIPOTENT

3. Blood components
PCV or Hematocrit
• 57% Plasma
• 1% Buffy coat – WBC
• 42% RBCs

4. Interpretation of
CBC- complete blood count

6. Component of the CBC
 White Blood Cells (WBCs)
 Red Blood Cells (RBCs)
 Hemoglobin (Hgb)
Hematocrit (Hct)
Mean Corpuscular Volume (MCV)
mean corpuscular hemoglobin(MCH)
Mean Corpuscular Hemoglobin
Concentration (MCHC)
Red cell distribution width (RDW)
Platelet ( PLT )

7. • RBC (varies with altitude):
M: 4.7 to 6.1 x10^12 /L
F : 4.2 to 5.4 x10^12 /L
In : 4.8 to 7.1 x10^12 /L
• Function: - transport hemoglobin which
carries oxygen from the lung to the
tissues
-acid –base buffer.

8. (Hgb/Hb)
M: 14 to 18 g/dL
F : 12 to 16 g/dL
In: 14 to 24 g/dl
5>Hgb>20 Emergency

9. Hematocrit
(HCT /PCV)
It is ratio of the volume of red cell to the volume of
whole blood.
M: 42 to 52 %
F : 37 to 47 %
In: 44 to 64 %
15>Hct>60 Emergency

10. – MCV = mean corpuscular volume
HCT/RBC count = 80-100fL
• small = microcytic
• normal = normocytic
• large = macrocytic
– MCHC= mean corpuscular hemoglobin concentration
HB/RBC count = 26-34%
• decreased = hypochromic
• normal = normochromic

11. • MCH (mean corpuscular hemoglobin)
HB/HCT = 27-32 pg
• RDW (red cell distribution width)
• It is correlates with the degree of
anisocytosis
_ Normal range from 10-15%

12. ADULT REFERENCES OF RED BLOOD CELLS
_________________________________________________
Male Female
_________________________________________________
Hemoglobin (g/dl) 14 –18 12 – 16
Hematocrit ; PCV (%) 42 -52 37 – 47
RBC count(X1012/l) 4.5 – 6.2 4– 5.5
Mean Cell Volume 80 -95 80 - 95
MCV (fl)
Mean Cell Hemoglobin 27 -34 27 - 34
MCH (pg)
Mean Cell Hemoglobin 30 -35 30 -35
Concentration(MCHC)

13. Normal CBC

14. RBC
Physiological response
Hypoxia
POLYCYTHEMIA VERA
Acute dehydration
RBC
Anemia
Hemorrhage.
nutritional deficiency
Kidney disease
Leukemia

15. Anaemia
Hb% < 12, Hct < 38%
Hypoproliferative Hemolytic
Retics < 2 Retics > 2

16. Anaemia Workup - MCV
Microcytic
MCV
Normocytic Macrocytic
Iron Deficiency -IDA
Chronic Infections
Thalassemias
Sideroblastic Anemia
Chronic disease
Early IDA
Hemoglobinopathies
Primary marrow disorders
Combined deficiencies
Increased destruction
Megaloblastic anemias
Liver disease/alcohol
Metabolic disorders

17. The causes of a hypochromic microcytic anaemia. These include lack of iron
(iron deficiency), or of iron release from macrophages to serum (anaemia of
chronic inflammation or malignancy). Failure of protoporphyrin synthesis
(sideroblastic anaemia) or of globin synthesis (Alpha or Beta Thalassaemia).

18. RDW
Megaloblastic anemias
IDA
Hemoglobinopathies
Hemolotic anemia

19. Microcytic Hypochromic - IDA

20. Macrocytosis -MBA

22. Norms of leukocytes(WBC)
30000<WBC<2500
Emergency

24. Normal CBC

25. • Leukocytosis increase WBCs.>11000
• Leukopenia decrease WBCs.<4000
• Granulocytosis neutrophilia
• Granulocytopenia neutropenia<2000/cmm
• Agranulocytosis neutropenia<500/cmm

26. The type of cell affected depends upon its primary
function:
In bacterial infections, neutrophils are most
commonly affected
In viral infections, lymphocytes are most
commonly affected
In parasitic infections, eosinophils are most
commonly affected.

27. Abnormal result of WBC
Leukocytosis
_ Infectious diseases
_Inflammatory disease(such as RA &allergy)
_Leukemia
_Severe emotional or physical stress
_Tissue damage (e.g. necrosis,or burns)

28. Leukopenia:
 Decreased WBC production from BM
 Irradiation
 Exposure to chemical or drugs
 Autoimmune disease
 Acute infection

29. • Function: Phagocytosis of bacteria
and cell debris

30. Neutrophilia
– Conditions associated with :
1-Bacterial infections (most common cause)
2-Tissue destruction
e.g. tissue infarctions, burns.
3- leukemoid reaction
4-Leukemia

31. Neutropenia
– this may result from:
1-Decreased bone marrow production
e.g. BM hypoplasia.
2-Ineffective bone marrow production
– E.g. megaloblastic anemias and
myelodysplastic syndromes.
3- post acute infection
_ e.g. typhoid fever, brucellosis.

32. • Function: Involved in allergy
, parasitic infections

33. Eosinophilia
may be found in
• Parasitic infections
• Allergic conditions and hypersensitivity
reaction

34. Basophilia.
Most uncommon
Seen in systemic hypersensitivity.

35. • T cells: cellular
(for viral infections)
• B cells: humoral
(antibody)
• Natural Killer Cells

36. Lymphocytosis
_ Viral infection
e.g. Infectious mononucleosis, CMV or pertussis.
_ Bacterial infection
e.g. TB
Lymphopenia
_Stress
_Steroid therapy
_ Irradiation & immunodeficincy disease

37. •Normal range; 150-400x10^3 /mm3
•Destroyed by macrophage cells in
the spleen.
•Function; involved in coagulation and
blood haemostasis.
50000 >PLT>1x10^6 Emergency

38. Thrombocytosis
• Exercise.
• High attitudes.
• Splenectomy
• RA
Thrombocytopenia
• Hypersplenism
• Haemorrhage.
• Bone marrow destruction or suppression e.g. Leukemia
• DIC
• Anemia

39. • Petechial hemorhage.
• Easy bruising.
• Mucosal bleeding
e.g. _ epistaxes.
_ gum bleeding

40. PANCYTOPENIA
1. Aplastic Anaemia
2. Megloblastic Anaemia
3. Bone marrow infiltration by leukaemias,
lymphomas, multiple myeloma etc.
4. Myelofibrosis
5. Hypersplenism( peripheral blood pancytopenia with
normocellular or hypercellular marrow and
splenomegaly)

41. Case 1

42. Case 2

43. Any
Question ?

44. Tnx
4
yr
attention
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