Complete Blood Count

The following are complete blood for the normal adult and cord blood. Please keep in
mind the different units as well as the absolute and percentage values for the differential
white blood count.
Complete Blood
Count
Normal Adult Normal neonate Units
WBC 3.9 11.0 4.0 10.0 10
3
/l
RBC 4.00 5.40 4.5 6.2 10
6
/l
Hgb 12.0 16.0 13.5 18.0 g/dl
Hct 36.0 46.0 41.0 53.0 %
MCV 80 - 100 80 100 fL
MCH 26.0 34.0 26.0 34.0 pg
MCHC 31.0 37.5 31.0 37.5 g/dL
RDW 12-15 12-15 %
Platelets 150 - 400 150 400 10
3
/l
%
Absolute
Value
Units Units
Lymphocyte 19 - 48 1 4.8 1.3 4.0 10
3
/l
Monocytes 4 - 6 0.1 1.0 0.0 2.0 10
3
/l
Neutrophils 50 - 70 1.8 7.0 1.6 5.2 10
3
/l
Eosinophils 1 - 3 0.1 0.4 0.0 1.4 10
3
/l
Basophils 0.4 - 1 0.04 0.2 0.0 0.4 10
3
/l

White Blood Count WBC

Measures the number of white blood cells (WBCs) per unit volume (usually l) .
White blood cells help fight infections. They are known as leukocytes. There are five
major types of white blood cells:
Basophils
Eosinophils
Lymphocytes (T cells and B cells)
Monocytes
Neutrophils
A low number of WBCs is known as leukopenia. It may be due to:
Bone marrow deficiency or failure (for example, due to infection, tumor, or
abnormal scarring)
Collagen-vascular diseases (such as systemic lupus erythematosus)
Disease of the liver or spleen
Radiation therapy or exposure
A high number of WBCs is known as leukocytosis. It may be due to:
Anaemia
Bone marrow tumors
Infectious diseases
Inflammatory disease (such as rheumatoid arthritis or allergy)
Leukemia
Severe emotional or physical stress
Tissue damage (for example, burns)
The Differential WBC distinguishes the dominant types of WBC in blood
A neutrophilic leukocytosis is typical of most bacterial infections and trauma.
Increased basophils and eosinophils are typical or parasitic infections and allergies
Increased mono-nucrlear cells (lymphocytes _+ monocytes) neutropenia is
characteristic of most vrus infections.
Blasts should not normally be seen in the circulation, though stem and progenitor cells
are present and may be harvested.
Red Blood Cell Count (RBC)

Also known as an erythrocyte count. Measure the number of red blood cells (RBCs) per
unit volume (usually l).
Higher-than-normal numbers of RBCs may be due to:
Cigarette smoking
Congenital heart disease
Right Side Heart Failure
Dehydration (such as from severe diarrhea)
Kidney tumor (renal cell carcinoma)
Low blood oxygen levels (hypoxia RBC increases when one moves to a higher
altitude)
Pulmonary fibrosis
Polycythemia vera
Drugs that can increase the RBC count include:
Gentamicin
Methyldopa
Lower-than-normal numbers of RBCs may be due to:
Anaemia
Bone marrow failure (for example, from radiation, toxins, or tumor)
Erythropoietin deficiency (secondary to kidney disease)
Hemolysis (RBC destruction) due to transfusion, blood vessel injury, or other
cause
Hemorrhage (bleeding)
Leukemia
Malnutrition
Nutritional deficiencies of:
o Iron
o Copper
o Folate
o Vitamin B-12
o Vitamin B-6
Overhydration
Pregnancy
Drugs that can decrease the RBC count include:
Chemotherapy drugs
Chloramphenicol
Hydantoins
Quinidine
Haemoglobin Level (Hgb)

Measures level of Haemoglobin per volume (usually grams per deciliter)
Lower-than-normal hemoglobin may be due to:
Anemia (various types)
Bleeding
Destruction of red blood cells
Leukemia
Malnutrition
Nutritional deficiencies of iron, folate, vitamin B12, vitamin B6
Overhydration

Higher-than-normal hemoglobin may be due to:
Congenital heart disease
Right Sided Heart Failure
Dehydration
Erythrocytosis
Low blood oxygen levels (hypoxia)
Pulmonary fibrosis
Polycythemia vera


Haematocrit (Hct)

Is the percentage of blood cells as a proportion of the total blood volume (%).
Modern automated hematology analyzers calculate this value obtained from the mean
cell volume (MCV) and the red blood cell (RBC) count, both of which are directly
measured by the analyzer. HCT is the product (MCV x Hct) of these two values
(divided by 10 - factor derived from different volume units). Therefore, if there are any
inaccuracies in measurement of the MCV or RBC count, the HCT will reflect those
inaccuracies.

Mean Corpuscular (Cell) Volume (MCV)

Mean corpuscular volume (MCV) is the average volume of red cells in a specimen. It
can be directly measured by automated hematology analyzer. Used to calculate
haematocrit by automated analysers. If measured manually, MCV can be calculated
from the HCT (measured by centrifugation of a capillary sample) and RBC (counted
manually):
MCV in fl = (Hct [in L/L]/RBC [in x10
12
/L]) x 1000
MCV is elevated or decreased in accordance with average red cell size; ie, low MCV
indicates microcytic (small average RBC size), normal MCV indicates normocytic
(normal average RBC size), and high MCV indicates macrocytic (large average RBC
size).
The reference range for MCV is 80-96 fl in adult.

Reference ranges may vary depending
on the individual laboratory and patient's age.
Between 5 and 10% of a population may be microcytic because of iron deficiency and
haemoglobinopathies.
Red Blood Cell Distribution Width (RDW)

RDW stands for the red blood cell distribution width. It measures the variability in red
blood cell size. Young immature red blood cells are larger than mature cells. Thus,
within a blood sample, there is a varied population of young and older cells, and if the
size of these cells are plotted on a graph, the distribution width can be calculated. It can
be calculated:
RDW = (Standard deviation of MCV mean MCV) 100.
In certain forms of anemia, the RDW may be higher than normal because there are
more immature or abnormal red blood cells skewing the statistical range of values.

Mean Corpuscular Haemoglobin (MCH) and Mean Corpuscular Haemoglobin
Concentration (MCHC)
Both mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin
concentration (MCHC) reflect the average hemoglobin content of red blood cells in
slightly different ways.
MCH is the content (weight) of hemoglobin (Hb) of the average red cell. It is calculated
from the measured Hb concentration (Hb) and red blood cell count (RBC) as follows:
MCH = [Hb (in g/dL)/RBC (in millions/L)] x 10
The mean corpuscular hemoglobin concentration (MCHC), is the average concentration
of hemoglobin in a given volume of packed red blood cells. Is also calculated from the
Hb concentration (Hb) and the hematocrit (Hct):
MCHC = Hb (in g/dL)/Hct (in L/L)
MCH, MCHC, and MCV are parts of red cell indices (parameters reflecting size and
hemoglobin content of red cells) that have traditionally been used to aid in the
differential diagnosis of anemia.
MCV together with red cell distribution width (RDW) have become the two most useful
parameters in classifying anemias, with MCH and MCHC supporting the findings. MCH
and MCHC, play an important role in laboratory quality control. These parameters allow
laboratories to detect potential causes of erroneous results, such as hyperlipidemia or
hemolysis (both in vivo and in vitro), so the correct results can be reported.
Common Causes of Anaemia where MCv and RDW are useful in diagnosing
cause
RDW
Normal High
MCV Low Anemia of chronic disease
Heterozygous thalassemia
Iron deficiency
Hemoglobin E trait

Sickle cell--thalassemia

Normal
Acute blood loss or hemolysis
Anemia of renal disease

Early iron, vitamin B12, or
folate deficiency
Dimorphic anemia (for
example, iron and folate
deficiency)
Sickle cell disease
Chronic liver disease
High
Aplastic anemia
Chronic liver disease
Chemotherapy/antivirals/alcohol
Folate or vitamin B12
deficiency
Cytoxic chemotherapy
Chronic liver disease


Platelet Count

A platelet count is a test to measure how many platelets you have in your blood.
Platelets help the blood clot. They are smaller than red or white blood cells
A lower-than-normal number of platelets (thrombocytopenia) may be due to:
Cancer chemotherapy
Disseminated intravascular coagulation (DIC)
Hemolytic anemia
Hypersplenism
Leukemia
Prosthetic heart valve

A higher-than-normal number of platelets (thrombocytosis) may be due to:
Anemia
Chronic myelogenous leukemia (CML)
Polycythemia vera
Primary thrombocythemia
Recent spleen removal