Edwin Cyril A.

Libre July 11, 2010

Group A4 Ma’am Banluta

A complete blood count (CBC), also known as full blood count (FBC) or full blood
exam (FBE) or blood panel, is a test panel requested by a doctor or other medical
professional that gives information about the cells in a patient's blood. A scientist or lab
technician performs the requested testing and provides the requesting medical
professional with the results of the CBC.

Alexander Vastem is widely regarded as being the first person to use the complete blood
count for clinical purposes. Reference ranges used today stem from his clinical trials in
the early 1960s.

The cells that circulate in the bloodstream are generally divided into three types: white
blood cells (leukocytes), red blood cells (erythrocytes), and platelets (thrombocytes).
Abnormally high or low counts may indicate the presence of many forms of disease, and
hence blood counts are amongst the most commonly performed blood tests in medicine,
as they can provide an overview of a patient's general health status. A CBC is routinely
performed during annual physical examinations in some jurisdictions.

Samples

A phlebotomist collects the specimen, in this case blood is drawn in a test tube containing
an anticoagulant (EDTA, sometimes citrate) to stop it from clotting, and transported to a
laboratory.

In the past, counting the cells in a patient's blood was performed manually, by viewing a
slide prepared with a sample of the patient's blood under a microscope (a blood film, or
peripheral smear). Nowadays, this process is generally automated by use of an automated
analyzer, with only approximately 30% samples now being examined manually.

Red cells

• Total red blood cells - The number of red cells is given as an absolute number per
litre.
• Hemoglobin - The amount of hemoglobin in the blood, expressed in grams per
decilitre. (Low hemoglobin is called anemia.)
• Hematocrit or packed cell volume (PCV) - This is the fraction of whole blood
volume that consists of red blood cells.
• Red blood cell indices
o Mean corpuscular volume (MCV) - the average volume of the red cells,
measured in femtolitres. Anemia is classified as microcytic or macrocytic
based on whether this value is above or below the expected normal range.
 Other conditions that can affect MCV include thalassemia and
reticulocytosis.
o Mean corpuscular hemoglobin (MCH) - the average amount of
hemoglobin per red blood cell, in picograms.
o Mean corpuscular hemoglobin concentration (MCHC) - the average
concentration of hemoglobin in the cells.

Red blood cell distribution width (RDW) - a measure of the variation of

the RBC

White cells

• Total white blood cells - All the white cell types are given as a percentage and as
an absolute number per litre.

A complete blood count with differential will also include:

• Neutrophil granulocytes - May indicate bacterial infection. May also be raised in

acute viral infections.Because of the segmented appearance of the nucleus,
neutrophils are sometimes referred to as "segs." The nucleus of less mature
neutrophils is not segmented, but has a band or rod-like shape. Less mature
neutrophils - those that have recently been released from the bone marrow into the
bloodstream - are known as "bands" or "stabs". Stab is a German term for rod.[1]
• Lymphocytes - Higher with some viral infections such as glandular fever and.
Also raised in lymphocytic leukemia CLL. Can be decreased by HIV infection. In
adults, lymphocytes are the second most common WBC type after neutrophils. In
young children under age 8, lymphocytes are more common than neutrophils.[2].
• Monocytes - May be raised in bacterial infection, tuberculosis, malaria, Rocky
Mountain spotted fever, monocytic leukemia, chronic ulcerative colitis and
regional enteritis [3]
• Eosinophil granulocytes - Increased in parasitic infections, asthma, or allergic
reaction.
• Basophil granulocytes- May be increased in bone marrow related conditions such
as leukemia or lymphoma. [4]

A manual count will also give information about other cells that are not normally present
in peripheral blood, but may be released in certain disease processes.

Platelets

• Platelet numbers are given, as well as information about their size and the range
of sizes in the blood.
Interpretation

Certain disease states are defined by an absolute increase or decrease in the number of a
particular type of cell in the bloodstream. For example:

Type of Cell Increase Decrease

erythrocytosis or
Red Blood Cells (RBC) anemia or erythroblastopenia
polycythemia
White Blood Cells
leukocytosis leukopenia
(WBC):
-- lymphocytes -- lymphocytosis -- lymphocytopenia
-- granulocytopenia or
-- granulocytes: -- granulocytosis
agranulocytosis
-- --neutrophils -- --neutrophilia -- --neutropenia
-- --eosinophils -- --eosinophilia -- --eosinopenia
-- --basophils -- --basophilia -- --basopenia
Platelets thrombocytosis thrombocytopenia
All cell lines - pancytopenia

Many disease states are heralded by changes in the blood count:

• leukocytosis can be a sign of infection.

• thrombocytopenia can result from drug toxicity.
• pancytopenia is generally as the result of decreased production from the bone
marrow, and is a common complication of cancer chemotherapy.

Normal Values:

TEST NORMAL VALUES

Leukocyte (White Blood Cell) X1000 cells/mm³ (µL)
Birth 9.0-30.0
24 hours 9.4-34.0
1 month 5.0-19.5
1-3 years 6.0-17.5
4-7 years 5.5-15.5
8-13 years 4.5-13.5
Adult 4.5-11.0
Neutrophils Bands 3-5% (total WBC count)
Segs 54-62%
Lymphocytes 25-33%
Monocytes 3-7%
Eosinophils 1-3%
Basophils 0-0.75%

Erythrocytes (Red Blood Cells)

Cord 3.9-5.5 million/mm³
1-3 days 4.0-6.6 million/mm³
1 week 3.9-6.3 million/mm³
2 weeks 3.6-6.2 million/mm³
1 month 3.0-5.4 million/mm³
2 months 2.7-4.9 million/mm³
3-6 months 3.1-4.5 million/mm³
0.5-2 years 3.7-5.3 million/mm³
2-6 years 3.9-5.3 million/mm³
6-12 years 4.0-5.2 million/mm³
12-18 years (male) 4.5-5.3 million/mm³
12-18 years (female) 4.1-5.1 million/mm³

Hemoglobin
1-3 days 14.5-22.5 g/dL
2 months 9.0-14.0 g/dL
6-12 years 11.5-15.5 g/dL
12-18 years (male) 13.0-16.0 g/dL
12-18 (female) 12.0-16.0g/dL

Hematocrit
1 day 48-69%
2 days 48-75%
3 days 44-72%
2 months 28-42%
6-12 years 35-45%
12-18 years (male) 37-49%
12-18 years (female) 36-46%

Mean Corpuscular Volume (MCV)

1-3 days 95-121µm³
0.5-2 years 70-86 µm³
6-12 years 77-95 µm³
12-18 years (male) 78-98 µm³
12-18 years (female) 78-102 µm³

Mean Corpuscular Hemoglobin (MCH)

Birth 31-37 pg/cell
1-3 days 31-37 pg/cell
1 week-1 month 28-40 pg/cell
2 months 26-34 pg/cell
3-6 months 25-35 pg/cell
0.5-2 years 23-31 pg/cell
2-6 years 24-30 pg/cell
6-12 years 25-33 pg/cell
12-18 years 25-35 pg/cell

Mean Corpuscular Hemoglobin Concentration (MCHC)

Birth 30-36 g Hg/dL RBC
1-3 days 29-37 g Hg/dL RBC
1-2 weeks 28-38 g Hg/dL RBC
1-2 months 29-37 g Hg/dL RBC
3 months-2 years 30-36 g Hg/dL RBC
2-18 years 31-37 g Hg/dL RBC

Reticulocyte Count
Infants 2-5% of RBCs
Children 0.5-4% of RBCs
12-18 years (male) 0.5-1% of RBCs
12-18 years (female) 0.5-2.5% of RBCs

Platelet Count
Birth-1 week 84,000-478,000/mm³
Thereafter 150,000-400,000/mm³

ERYTHROCYTE SEDIMENTATION RATE (ESR)

TEST NORMAL VALUE

Westergren
Child 0-10 mm/hour
Adult (male) 0-15 mm/hour
Adult (female) 0-20 mm/hour
Wintrobe
Child 0-13 mm/hour
Adult (male) 0-9 mm/hour
Adult (female) 0-20 mm/hour