INTERPRETATION OF FULL
BLOOD COUNT
CLEMENT AWUAH
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Key points/purpose
Provide an overview of the use of the FBC
Discuss aspects of reduced and elevated
results of some parameters in FBC
Relate a few blood pictures to the FBC run
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Introduction 1/3
FBC is probably the
commonest test done
(“full blood count”-
how much of each
type of cell).
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Introduction 2/3
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Introduction 3/3
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WHY FBC????
To review your overall health.
To diagnose a medical condition.
To monitor a medical condition.
To monitor medical treatment.
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Results Components 1/4
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Results Components 2/4
WBC = White Blood Cells
LYM = Lymphocyte
MID = WBC not classified as LYM or GRA
GRA = Granulocytes (neutrophil, basophil
,eosinophil)
LYM% = (Lymphocyte)%
MID % = Medicalese (WBC not classified as LYM
or GRA)%
GRA% = (Granulocytes)%
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Results Components 3/4
RBC = Red Blood Cells
HGB = Haemoglobin
HCT = Haematocrit
MCV = Mean Cell Volume
MCH = Mean Cell Hemoglobin
MCHC = Mean Cell Hemoglobin Concentration
RDW = Red Cell Distribution Width
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Results Components 4/4
PLT = Platelet
P_LCC = Macro platelet count
P_LCR = Macro platelet percentage
PCT = Platelet percentage
MPV = Mean platelet volume
PDWcv = Platelet Distribution Width
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Neutrophils – Low
Most common causes
Viral
Autoimmune/Idiopathic
Drugs
Red flags
Person Particularly Unwell
Severity
Rate of change of Neutropenia
Lymphadenopathy, Hepatosplenomegaly
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Neutrophils – High
Most common causes
Infection/Inflammation
Necrosis/Malignancy
Any Stress or Heavy Exercise
Drugs
Pregnancy
CML (Chronic Myelogenous Leukemia)
Red Flags
Person particularly unwell
Severity
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Lymphocytes
Lymphocyte – Low
Not usually clinically significant
Could indicate hypo proliferative BM or suppression
Lymphocyte – High
Isolated elevated count not usually significant
Acute Infection (Viral, Bacterial)
Smoking
Hyposplenism
Acute Stress Response
Autoimmune Thyroiditis
CLL (Chronic Lymphocytic Leukemia)
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Monocytes
Monocytes – Low
Not clinically significant
Monocytes – High
Chronic infection
An autoimmune or blood disorder
Cancer
Viral Infection
Tuberculosis
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Eosinophil
Eosinophil – Low
No real cause for concern
Eosinophil – High
Allergy: Asthma
Parasites
Rarer causes
Hodgkins Disease
Myeloproliferative Disorders
Churg-strauss Syndrome
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Basophils
Basophils – Low
Difficult to demonstrate
Basophils – High
Myeloproliferative disorders
Allergies: food allergies, drug allergies, allergic
rhinitis
Infections: chickenpox, tuberculosis
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Platelets – Low
Most common causes
Viral Infection
Idiopathic Thrombocytopenic Purpura
Liver Disease
Drugs
Hypersplenism
Autoimmune Disease
Pregnancy
Red Flags
Bruising
Petechiae
Signs of bleeding
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Platelets – High
Reactive conditions eg. infection, inflammation
Pregnancy
Severe Iron deficiency
Post splenectomy
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Red Blood Cells
‘What is the size of RBC’ ?
MCV indicates the Red cell volume (size)
Both the MCH & MCHC tell Hb content of RBC.
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The Three Basic Measures
A. RBC count
B. Hemoglobin
C. Haematocrit
Check whether this holds good in given results
A x 3 = ((B) x 3) = C (This is the rule of thumb)
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High haemoglobin
Hb is often accompanied by PCV
Can reflect decreased plasma volume (eg:
dehydration, alcohol, cigarette smoking,
diuretics) or
Increased red cell mass (eg. polycythaemia)
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MCV
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Classification of Anaemia
Using MCV to classify the anaemia
Microcytic, MCV < 80 fl
Normocytic, MCV 80 – 100 fl
Macrocytic, MCV > 100 fl
Using MCH to classify the anaemia
•Hypochromic, MCH < 27 pg
•Normochromic, MCH 27-34 pg
•Hyperchromic, MCH > 34 pg
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What is your take?
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