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Understanding Blood Counts: Normal & Abnormal Hemoglobin, Hematocrit, & WBC Values, Lecture notes of Biology

An in-depth explanation of various components of a complete blood count (cbc) test, including hemoglobin (hb), hematocrit (hct), mean corpuscular hemoglobin (mch), mean corpuscular hemoglobin concentration (mchc), red cell distribution width (rdw), reticulocyte count, platelet count, and white blood cell (wbc) count with its subtypes. It discusses normal ranges, conditions causing abnormal values, and the significance of these values in diagnosing various health conditions.

Typology: Lecture notes

2021/2022

Uploaded on 09/27/2022

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Basic Laboratory Tests
Complete Blood Counts (CBC)
Test Alternative
Names Units Usual
Normal Range
Examples of conditions
in which abnormal values
occur
Hemoglobin Hb or Hgb g/dL Males: 13.6-17.5 g/dL
Females: 12-16 g/dL
Levels are reduced with bleeding,
iron deficiency, pernicious
anemia, hemolytic anemia,
aplastic anemia
Increased levels occur with
polycythemia vera, smoking, living
at high altitude
Hematocrit Hct % Males: 39%-49%
Females: 35%-45%
Same as Hemoglobin
Red Blood Cell Count RBC Number x 10
6
cells/mm3 Males: 4.3-5.9 x10
6
/mm
3
Females: 3.5-5 x106/mm3
Same as Hemoglobin
Mean Corpuscular Volume MCV Cubic
micomillimeters
(μm3)
80-100 mm
3
Low levels are seem with iron
deficiency, thalassemia minor
High levels are found with vitamin
B12 deficiency, alcohol abuse
Mean Corpuscular
Hemoglobin MCH picrograms (pg) 24-34 pg Low levels are seen with iron
deficiency, thalassemia minor
High levels are found with vitamin
B12 deficiency
Mean Corpuscular
Hemoglobin Concentration MCHC g/dL 33-37 g/dl Low levels are found with iron
deficiency anemia, thalassemia
High levels are seen with
hereditary spherocytosis
Red cell distribution width
index RDW % 11.5% to 14.5% High levels are found with Iron
deficiency anemia
Reticulocyte count Retic % 0.5% to 1.5% Increased levels are seen with
blood loss or hemolytic anemia
Inappropriately decreased levels
are found with iron deficiency,
aplastic anemia
Platelet Count Plate Number x
103/mm3 150-450 × 10
3
/mm
3
Levels are decreased with
idiopathic thrombocytopenia
purpura, disseminated idiopathic
coagulopathy, spleen
enlargement
High levels are seen with iron
deficiency anemia, infections,
essential thrombocythemia
Total White Blood Cell Count WBC or WC Number x 10
3
cells/mm3 4.5- 11 × 10
3
/mm
3
High or low levels are associated
with an increase or decrease of
one or more of the different
subtypes of white blood cells.
Polymorphic neutrophils
(Neutrophils) PMNs,
Mature
neurtophils,
segmented
forms, segs
% or
absolute
number x
103/mm3
60-70% or
1.8-7.7 x103/mm3
Levels are increased with
bacterial infections, inflammatory
disorders, physical and emotional
stress, steroid medications
Low levels are found with aplastic
anemia, secondary to radiation or
chemotherapy, hereditary
conditions
Band forms Bands, stabs,
juvenile
forms
% or
absolute
number x
103/mm3
2-6% or
0-0.07 x103/mm3
Increased values are seen with
severe bacterial infection, severe
inflammatory conditions and
recovery of bone marrow function
after suppression
Lymphocytes Lymphs % or
absolute
number x
25-40% or
1.0-4.8 x103/mm3
Increased in viral infections,
radiation treatment, some types of
leukemia.
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Basic Laboratory Tests

Complete Blood Counts (CBC)

Test

Alternative Names Units

Usual Normal Range

Examples of conditions in which abnormal values occur Hemoglobin Hb or Hgb g/dL Males: 13.6-17.5 g/dL Females: 12-16 g/dL

Levels are reduced with bleeding, iron deficiency, pernicious anemia, hemolytic anemia, aplastic anemia Increased levels occur with polycythemia vera, smoking, living at high altitude Hematocrit Hct % Males: 39%-49% Females: 35%-45%

Same as Hemoglobin

Red Blood Cell Count RBC Number x 10^6 cells/mm 3

Males: 4.3-5.9 x10^6 /mm^3 Females: 3.5-5 x10 6 /mm^3

Same as Hemoglobin

Mean Corpuscular Volume MCV Cubic micomillimeters (μm^3 )

80-100 mm^3 Low levels are seem with iron deficiency, thalassemia minor High levels are found with vitamin B12 deficiency, alcohol abuse Mean Corpuscular Hemoglobin

MCH picrograms (pg) 24-34 pg Low levels are seen with iron deficiency, thalassemia minor High levels are found with vitamin B12 deficiency Mean Corpuscular Hemoglobin Concentration

MCHC g/dL 33-37 g/dl Low levels are found with iron deficiency anemia, thalassemia High levels are seen with hereditary spherocytosis Red cell distribution width index

RDW % 11.5% to 14.5% High levels are found with Iron deficiency anemia

Reticulocyte count Retic % 0.5% to 1.5% Increased levels are seen with blood loss or hemolytic anemia Inappropriately decreased levels are found with iron deficiency, aplastic anemia Platelet Count Plate Number x 10 3 /mm^3

150-450 × 10^3 /mm^3 Levels are decreased with idiopathic thrombocytopenia purpura, disseminated idiopathic coagulopathy, spleen enlargement High levels are seen with iron deficiency anemia, infections, essential thrombocythemia Total White Blood Cell Count WBC or WC Number x 10^3 cells/mm 3

4.5- 11 × 10^3 /mm^3 High or low levels are associated with an increase or decrease of one or more of the different subtypes of white blood cells. Polymorphic neutrophils (Neutrophils)

PMNs, Mature neurtophils, segmented forms, segs

% or absolute number x 10 3 /mm^3

60-70% or 1.8-7.7 x10 3 /mm^3

Levels are increased with bacterial infections, inflammatory disorders, physical and emotional stress, steroid medications Low levels are found with aplastic anemia, secondary to radiation or chemotherapy, hereditary conditions Band forms Bands, stabs, juvenile forms

% or absolute number x 10 3 /mm^3

2-6% or 0-0.07 x10 3 /mm^3

Increased values are seen with severe bacterial infection, severe inflammatory conditions and recovery of bone marrow function after suppression Lymphocytes Lymphs % or absolute number x

25-40% or 1.0-4.8 x10 3 /mm^3

Increased in viral infections, radiation treatment, some types of leukemia.

10 3 /mm^3 Low levels are seen with immunodeficiency states, systemic lupus, bone marrow failure, late stage HIV disease Monocytes Monos % or absolute number x 10 3 /mm^3

2-8% or 0-0.8 x10 3 /mm^3

High levels are found in chronic inflammatory disorders, some infections, Hodgkin’s disease, some types of leukemia Low levels may be seen with steroid medication usage Eosinophils Eos % or absolute number x 10 3 /mm^3

1-4% or 0-0.45 x10 3 /mm^3

Increased levels are seen in parasitic infections, allergic disorders, eczema, asthma, some types of leukemia Decreased levels are found with excess steroid levels, stress reactions Basophils Baso % or absolute number x 10 3 /mm^3

0-1% or 0-0.2 x10 3 /mm^3

Increased levels are found in myeloproliferative disorders, some types of leukemia, inflammatory conditions Decreased levels are found with stress reactions, prolonged steroid medication therapy, hyperthyroidism

Complete Blood Count (CBC)

Hemoglobin (Hb) Hemoglobin (Hb) is a measurement of the amount of the oxygen carrying protein hemoglobin per unit volume present in the blood. Hemoglobin is found within red blood cells and gives these cells their characteristic red color. Hemoglobin levels are generally higher in males than females. A reduction in the hemoglobin level is called anemia and may result from excess blood loss, premature destruction of red cells or reduced production of new cells. Hemoglobin levels that are higher than normal (polycythemia) may be detected in individuals who live at high altitude, in smokers and in some other pathologic conditions that lead to abnormally excessive production red blood cells.

Hematocrit (Hct) The hematocrit (Hct) is a measure of the amount of space or volume that the red blood cells occupy in the blood. It is generally reported at a percentage. Thus, a hematocrit reported as 40% indicates that the red blood cells occupy 40% of a given volume of blood. As with the hemoglobin, the hematocrit is generally higher in males than females. The same factors that affect the hemoglobin will affect the hematocrit and in the same way.

Red Blood Cell Count (RBC) The red blood cell count (RBC) is the number of red blood cells per unit volume of blood. As with the hemoglobin and hematocrit, the red blood cell count is higher in males than females. Anemia and polycythemia cause a decrease and increase in the red blood cell count respectively.

Mean Corpuscular Volume (MCV) The mean corpuscular volume (MCV) is a measure of the average size or volume of the individual red blood cells. The MCV can provide valuable clues to the possible causes of anemia. Failure to produce adequate hemoglobin results in smaller than normal cells and a low MCV. Iron deficiency anemia is an example of a condition with a lower than normal MCV. Thalassemia is an inherited condition that also produces anemia with a low MCV. Anemia associated with abnormal cell division in the production of red blood cells (for example vitamin B12 deficiency) is associated with larger than normal red blood cells or an elevated MCV. Chronic alcohol abuse may also lead to an increased MCV.

measurement. An increase in the band forms usually indicates increased production of PMNs, most often in response to a serious bacterial infection. Band forms may be increased with severe inflammatory conditions or bone marrow recovery after an insult that had previously reduced production.

Lymphocytes (Lymphs) Lymphocytes are white blood cells that are important components of the immune system. There are two main types of lymphocytes: B cells which produce antibodies and T cells which function to eliminate body cells that are infected with viruses or altered by cancer. These lymphocyte subtypes require special testing for identification and are not considered part of the complete blood count. Lymphocytes also produce substances called cytokines that are important in augmenting and modifying immune responses. Lymphocyte counts are increased in viral and certain bacterial infections, radiation treatment and some forms of leukemia. Reduced counts are found with immunodeficiency diseases, severe sepsis, systemic lupus, bone marrow failure, medication reactions and the late stages HIV infection.

Monocyte (Monos) Monocytes are the largest of the white blood cells. Monocytes digest damaged cells and other material. They work with lymphocytes as an important part of the immune process. Monocytes may migrate from blood vessels into body tissues in response to damage or immune stimulation. These tissue monocytes are known as macrophages. Monocytes counts are increased with chronic inflammatory disorders, some infections, Hodgkin’s disease and some forms of leukemia. Low monocyte counts may be seen with steroid medication use.

Eosinophils (Eos) Eosinophils are white blood cells that are primarily involved in the body defense against parasitic infections. Eosinophils are also involved in allergic reactions. Eosinophils counts are increased in parasitic infections, allergic disorders, asthma, eczema, autoimmune disease and some forms of leukemia. Eosinophil counts are decreased by corticosteroids and stress reactions.

Basophils (Basos) Basophils are white blood cells that are important components of the immune system. They are also involved in allergic reactions. They are capable of ingesting foreign material. They contain and, under appropriate stimulation, release chemicals that are important in the immune process. Basophil levels are increased in myeloproliferative diseases, some types of leukemia and inflammatory conditions. Basophil counts may be decreased with stress reactions, prolonged corticosteroid therapy and an overactive thyroid gland