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Complete blood count copy.pptx
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- 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 theconcentration 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) • Percentageof 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 cellindices • 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) • Irondeficiency 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 distributionwidth (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 RDWand 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 RDWand 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 • Itis 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 reticulocytecount: • 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 cellcount • Reference range : 4-11 x 10^9/L • Leucopenia : decreased WBC count • Leucocytosis : increase WBC count
- 22. Low WBC countor 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 Postchemotherapy , 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 Autoimmunedisorders 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 Aplasticanaemia 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 • Plateletsplay 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
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