What is a hematocrit test. How is it related to a complete blood count. Why are these tests important for diagnosing various health conditions. What do low hematocrit levels indicate. How can abnormal blood cell counts impact your health.

Decoding the Hematocrit Test: A Key Component of the Complete Blood Count

The hematocrit test is a crucial part of the complete blood count (CBC), a comprehensive blood test that provides valuable insights into an individual’s overall health. This test measures the percentage of blood volume occupied by red blood cells, offering essential information about the body’s ability to transport oxygen effectively.

A CBC examines three main types of blood cells:

• Red blood cells (RBCs)
• White blood cells (WBCs)
• Platelets

The hematocrit, specifically, focuses on red blood cells and their concentration in the blood. This measurement is critical for identifying various health conditions, including anemia, dehydration, and certain blood disorders.

Key Components of a Complete Blood Count

A CBC provides a wealth of information about blood cells and their characteristics. Some of the key measurements include:

1. Total number of red blood cells (RBC count)
2. Total amount of hemoglobin in the blood
3. Percentage of blood made up of red blood cells (hematocrit)
4. Average red blood cell size (mean corpuscular volume)
5. Average weight of hemoglobin per red blood cell (mean corpuscular hemoglobin)
6. Average amount of hemoglobin per red blood cell (mean corpuscular hemoglobin concentration)
7. Total number of white blood cells
8. Number of each type of white blood cell (WBC differential)
9. Number of platelets (platelet count)

These measurements collectively provide a comprehensive picture of an individual’s blood health, enabling healthcare providers to detect and diagnose various conditions effectively.

The Significance of Low Hematocrit Levels: Causes and Implications

Low hematocrit levels, also known as low HCT, can be indicative of several health issues. But what exactly constitutes a low hematocrit level? Generally, hematocrit levels below 36% for women and 41% for men are considered low. However, these values may vary slightly depending on the laboratory and individual factors such as age and overall health status.

Several factors can contribute to low hematocrit levels:

• Anemia
• Blood loss or hemorrhage
• Nutritional deficiencies (particularly iron, vitamin B12, or folate)
• Bone marrow disorders
• Chronic diseases
• Certain medications, including chemotherapy drugs

When hematocrit levels are low, it often indicates a decreased ability of the blood to carry oxygen effectively throughout the body. This can lead to various symptoms, including fatigue, weakness, shortness of breath, and dizziness.

Anemia: A Common Cause of Low Hematocrit

Anemia is one of the most frequent causes of low hematocrit levels. It occurs when there aren’t enough healthy red blood cells to carry adequate oxygen to the body’s tissues. There are several types of anemia, each with its own underlying causes:

• Iron-deficiency anemia
• Vitamin B12 deficiency anemia (pernicious anemia)
• Folate deficiency anemia
• Hemolytic anemia
• Sickle cell anemia
• Aplastic anemia

Identifying the specific type of anemia is crucial for determining the appropriate treatment approach. This is where the comprehensive nature of the CBC becomes particularly valuable, as it provides additional information about red blood cell characteristics that can help pinpoint the underlying cause of low hematocrit levels.

Beyond Hematocrit: Understanding Other CBC Components and Their Implications

While the hematocrit test is a crucial part of the CBC, other components of this comprehensive blood test provide equally important information about an individual’s health status. Understanding these components can offer deeper insights into potential health issues and guide further diagnostic and treatment decisions.

Red Blood Cell Count and Hemoglobin Levels

The red blood cell count and hemoglobin levels are closely related to the hematocrit. Hemoglobin is the protein in red blood cells responsible for carrying oxygen. Low levels of both RBCs and hemoglobin often accompany low hematocrit levels and can indicate various forms of anemia or other blood disorders.

White Blood Cell Count and Differential

The white blood cell count and differential provide crucial information about the body’s immune system. Abnormalities in WBC counts can indicate various conditions:

• Low WBC count (leukopenia): May suggest viral infections, severe bacterial infections, or bone marrow suppression
• High WBC count (leukocytosis): Could indicate infections, leukemia, or inflammatory conditions

The WBC differential, which breaks down the numbers of different types of white blood cells, can offer more specific insights into the nature of any immune system irregularities.

Platelet Count

Platelets play a crucial role in blood clotting. Abnormal platelet counts can have significant implications:

• Low platelet count (thrombocytopenia): May increase the risk of bleeding and bruising
• High platelet count (thrombocytosis): Could increase the risk of blood clots

Understanding these various components of the CBC allows healthcare providers to form a more comprehensive picture of an individual’s blood health and overall well-being.

The CBC in Cancer Diagnosis and Monitoring: A Vital Tool

The complete blood count plays a crucial role in the diagnosis, treatment, and monitoring of various types of cancer. Abnormalities in blood cell counts can often be early indicators of certain cancers or can help track the progression of the disease and the effectiveness of treatments.

CBC Abnormalities Associated with Cancer

Several types of cancer can cause abnormalities in blood cell counts:

• Leukemia: Often characterized by abnormal white blood cell counts and immature blood cells in the bloodstream
• Lymphoma: May cause low red blood cell counts (anemia) or abnormal white blood cell counts
• Multiple myeloma: Can lead to anemia and low platelet counts
• Myelodysplastic syndromes: Often result in low counts of one or more types of blood cells

It’s important to note that while these abnormalities can be indicative of cancer, they can also be caused by many other conditions. Therefore, additional tests are typically required to confirm a cancer diagnosis.

Monitoring Cancer Treatment with CBC

During cancer treatment, regular CBCs are often performed to:

1. Monitor the effects of chemotherapy on blood cell production
2. Detect potential complications, such as anemia or increased risk of infection
3. Assess the need for supportive treatments, such as blood transfusions or growth factor medications
4. Evaluate the effectiveness of treatment in certain blood cancers

By closely monitoring blood cell counts throughout treatment, healthcare providers can make informed decisions about adjusting treatment protocols and managing side effects effectively.

The CBC Procedure: What to Expect During the Test

Understanding the process of a CBC can help alleviate any anxiety associated with the test. The procedure is relatively simple and typically takes only a few minutes to complete.

Preparation for the Test

In most cases, no special preparation is required for a CBC. However, there are a few considerations:

• Inform your healthcare provider about any medications you’re taking, as some can affect CBC results
• Fasting is usually not necessary unless other blood tests are being performed simultaneously
• Wear comfortable clothing with sleeves that can be easily rolled up

The Blood Draw Process

The actual blood draw typically follows these steps:

1. A healthcare professional will clean the area, usually the inside of your elbow or back of your hand, with an antiseptic
2. An elastic band may be tied around your upper arm to make the veins more visible
3. A small needle is inserted into the vein to draw blood
4. The blood is collected in one or more vials
5. The needle is removed, and pressure is applied to the site with a cotton ball or bandage

The entire process usually takes less than five minutes. While you may feel a brief sting when the needle is inserted, the procedure is generally painless.

After the Test

After the blood draw, you can typically resume your normal activities immediately. Some minor bruising or soreness at the site of the blood draw may occur but should resolve quickly. If you experience any unusual symptoms, such as prolonged bleeding or severe pain, contact your healthcare provider.

Interpreting CBC Results: Understanding the Numbers

Interpreting CBC results can be complex, as the significance of the numbers depends on various factors, including age, sex, and overall health status. However, understanding some basic principles can help you better comprehend your test results.

Normal Ranges and Variations

CBC results are typically compared to reference ranges, which can vary slightly between laboratories. Some general guidelines for normal adult ranges include:

• Red blood cell count: 4.5 to 5.5 million cells/mcL for men; 4.0 to 5.0 million cells/mcL for women
• Hemoglobin: 13.5 to 17.5 grams/dL for men; 12.0 to 15.5 grams/dL for women
• Hematocrit: 38.8% to 50% for men; 34.9% to 44.5% for women
• White blood cell count: 4,500 to 11,000 cells/mcL
• Platelet count: 150,000 to 450,000/mcL

It’s important to note that these ranges are general guidelines, and individual results should always be interpreted by a healthcare professional in the context of your overall health and any symptoms you may be experiencing.

Common Terminology in CBC Results

Understanding some common terms used in CBC results can help you better comprehend your test report:

• Anemia: Low red blood cell count or hemoglobin levels
• Leukopenia: Low white blood cell count
• Leukocytosis: High white blood cell count
• Thrombocytopenia: Low platelet count
• Thrombocytosis: High platelet count

These terms describe general conditions indicated by abnormal blood cell counts, but the underlying causes can vary widely and often require further investigation.

Beyond the Numbers: The Importance of Clinical Context in CBC Interpretation

While the numerical results of a CBC provide valuable information, it’s crucial to understand that these numbers alone don’t tell the whole story. The interpretation of CBC results must always be done in the context of an individual’s overall health status, symptoms, medical history, and other diagnostic tests.

The Role of Clinical Symptoms

CBC results often become more meaningful when considered alongside a patient’s symptoms. For example:

• Low hematocrit levels might explain symptoms like fatigue, weakness, or shortness of breath
• Elevated white blood cell counts could corroborate symptoms of infection, such as fever or body aches
• Low platelet counts might account for easy bruising or prolonged bleeding

The presence or absence of symptoms can help guide the interpretation of CBC results and inform decisions about further testing or treatment.

Medical History and Risk Factors

An individual’s medical history and risk factors play a crucial role in interpreting CBC results. Factors that may influence the interpretation include:

• Chronic medical conditions
• Recent illnesses or infections
• Medications
• Family history of blood disorders or certain cancers
• Lifestyle factors (e.g., smoking, alcohol consumption)

These factors can help healthcare providers contextualize CBC results and determine whether abnormalities are likely to be significant or require further investigation.

The Need for Further Testing

In many cases, abnormal CBC results may prompt additional testing to determine the underlying cause. These follow-up tests might include:

• Blood smear examination
• Iron studies
• Vitamin B12 and folate tests
• Bone marrow biopsy
• Genetic testing

The decision to pursue further testing is based on the specific abnormalities found in the CBC, the patient’s symptoms and medical history, and the healthcare provider’s clinical judgment.

Understanding the importance of clinical context in interpreting CBC results highlights the value of open communication with your healthcare provider. Discussing your results, symptoms, and concerns can lead to a more accurate diagnosis and appropriate treatment plan.

Complete blood count (CBC) | Canadian Cancer Society

A complete blood count (CBC) is a blood test that examines the numbers and features of blood cells. The 3 types of cells it examines are red blood cells (RBCs), white blood cells (WBCs) and platelets.

A CBC measures the following:

• total number of red blood cells (the RBC count)
• total amount of hemoglobin in the blood
• percentage of blood made up of red blood cells (the hematocrit)
• average red blood cell size (the mean corpuscular volume)
• average weight of hemoglobin per red blood cell (the mean corpuscular hemoglobin)
• average amount of hemoglobin per red blood cell (the mean corpuscular hemoglobin concentration)
• total number of white blood cells
• number of each type of white blood cell (the WBC differential), including neutrophils (the absolute neutrophil count, or ANC)
• number of platelets (the platelet count)

A CBC is a common blood test. It is often done as part of a routine checkup, but can be done at any time.

A CBC may be done to:

• learn information about your general health
• check how well the bone marrow and spleen are working
• help diagnose diseases and conditions that affect blood cells, such as anemia, infection, blood disorders or leukemia
• provide a baseline to compare with future CBCs
• check for bone marrow suppression
• monitor a condition (as a part of follow-up)

A CBC is usually done in a community lab or hospital.

You may be given special instructions to follow before having a CBC done. Some medicines may affect CBC results, so you may be asked to stop taking certain medicines before a CBC. Check with the lab to see if you should avoid any medicines and for how long.

Blood is usually taken from a vein in the arm. An elastic band (tourniquet) is wrapped around your upper arm to apply pressure to the area and make the veins easier to see. You may be asked to make a fist so the veins stand out more. The skin is cleaned and disinfected. A needle is inserted into the vein and a small amount of blood is removed. You may feel a prick or stinging sensation.

The blood is collected in a tube and labelled with your name and other identifying information. Sometimes more than one tube of blood is collected. The tourniquet is removed and the needle is withdrawn. You may feel mild discomfort when the needle is withdrawn. Pressure is applied to the area where the needle was inserted until bleeding stops. A small bandage may be put on the area.

The blood collected is examined by a specialist in the lab (a lab technologist) using microscopes and other special equipment.

A CBC does not usually cause any side effects. If side effects happen, they are usually minor and happen at the needle site. Side effects that may happen include:

• discomfort
• bleeding
• bruising
• swelling
• infection

CBC results are given as numbers and often depend on certain factors including sex, age and medical history. They should be compared to a normal reference range or to previous results to have meaning. Normal ranges for CBCs may vary slightly from lab to lab.

A CBC usually provides general information that can give doctors clues to possible health problems. Information from a CBC helps doctors decide whether other tests or procedures are needed to make a diagnosis. The information may also help your doctor develop or revise treatment plans.

A doctor familiar with your medical history and overall health is the best person to explain your CBC results and what they mean for you.

Common terms used to describe CBC results are:

• anemia – not having enough healthy RBCs or hemoglobin
• leukopenia – a low number of WBCs
• neutropenia – a low number of neutrophils
• leukocytosis – an increased number of WBCs
• thrombocytopenia – a low number of platelets
• thrombocytosis – an increased number of platelets

CBC results can be low or high for many reasons. Some examples of abnormal CBC results related to cancer are listed below.

A low RBC count may be due to:

• anemia due to prolonged bleeding or blood loss (hemorrhage), a diet lacking iron or certain vitamins, certain types of chemotherapy, blood disorders or chronic disease
• Hodgkin lymphoma and other lymphomas
• cancers of the blood, such as leukemia and multiple myeloma
• some myeloproliferative disorders

A high RBC count may be due to:

• dehydration, such as from severe diarrhea
• kidney tumours
• lung diseases
• polycythemia vera (a myeloproliferative disorder)

A low WBC count may be due to:

• viral infection
• severe bacterial infection
• bone marrow suppression caused by treatments like chemotherapy or radiation therapy
• bone marrow diseases, such as leukemia or myelodysplastic syndrome (MDS)
• anemia

A high WBC count may be due to:

• infection
• leukemia
• some myeloproliferative disorders
• some types of cancer, such as bronchogenic carcinoma
• certain drugs, such as colony-stimulating factors
• stress, allergies or tissue injury

A low platelet count may be due to:

• some types of cancer, such as leukemia or lymphoma
• autoimmune diseases
• bacterial infection
• viral infection
• chemotherapy or radiation therapy
• having many blood transfusions
• certain drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) including acetylsalicylic acid (ASA, Aspirin, salicylate) and ibuprofen (Motrin, Advil, Nuprin)

A high platelet count may be due to:

• prolonged bleeding or blood loss (hemorrhage)
• anemia from low iron levels
• infection (inflammation)
• surgical removal of the spleen (splenectomy)
• polycythemia vera
• some types of leukemia

Your doctor may recommend more tests, procedures, follow-up care or treatment. Sometimes therapies or doses may need to be changed to avoid problems when blood cell counts are low.

Blood samples may need to be taken from very small blood vessels (called capillaries) in a finger or heel of an infant or young child. This is done by pricking the skin with a needle.

Preparing children before a test or procedure can help lower their anxiety, increase their cooperation and develop their coping skills. This includes explaining to children what will happen during the test, such as what they will see, feel and hear.

Parents or caregivers can help reassure and prepare children by giving them brief but accurate information about what will happen, such as:

• A big rubber band that feels like a balloon will be placed around your arm. This will feel tight, like someone is squeezing your arm.
• When your skin is cleaned it will feel cold.
• When the needle is placed in your arm, you will feel a prick or pinch. It may sting or hurt a little, or it may not hurt at all.
• Once the needle is in your arm, you will see the blood come out into a tube. You can look away if you don’t want to watch this.

Children may worry about not having enough blood after some has been taken from their arm. You can reassure them that bodies make new blood all the time and that their body will not run out of blood.

Parents or caregivers can help distract children during blood tests to help make it easier for them.

Toddlers (1 to 2 years) might like to watch bubbles or toys that move or make sounds, such as magic wands, light-up toys or pinwheels. They may want to hold their favourite toy.

Preschoolers (3 to 5 years) may want to hold a favourite toy or watch toys that light up and make sounds.

School-age children (6 to 12 years) may want to:

• look at items, such as magic wands, light-up toys, video games and picture or “search and find” books
• bring their favourite stuffed animal or toy to hold
• blow bubbles or practise deep breathing while blowing bubbles
• imagine their favourite place
• hear a joke or story or tell you a joke or story

Teenagers (13 to 18 years) can try deep breathing or imagining their favourite place. They also might want to hear a joke or story.

Preparing a child for a blood test depends on the age and experience of the child. Find out more about helping your child cope with tests and treatments.

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• American Cancer Society. Understanding Your Lab Test Results. 2016: https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-lab-test-results.html.

• American Society of Clinical Oncology. Complete Blood Count Tests. 2017: https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/reports-and-results/complete-blood-count-tests.

• Cancer Research UK. Blood Tests. Cancer Research UK; 2015: http://www.cancerresearchuk.org/about-cancer/cancer-in-general/tests/blood-tests.

• Chabner BA, Chabner Thompson E
  . Cancer diagnosis. Beers MH, Berkow R (eds.). Merck Manual Professional Edition. 2013: http://www.merckmanuals.com/en-ca/professional/hematology-and-oncology/overview-of-cancer/cancer-diagnosis.

• CureSearch. Blood Studies. Bethesda, MD: National Childhood Cancer Foundation & Children’s Oncology Group; https://curesearch.org/Blood-Studies.

• Fischbach FT, Fischbach MA. Fischbach’s A Manual of Laboratory and Diagnostic Tests. 10th ed. Wolters Kluwer; 2018.

• Leukemia and Lymphoma Society of Canada. Blood Tests. http://www.llscanada.org/managing-your-cancer/lab-and-imaging-tests/blood-tests.

• National Cancer Institute. Understanding Laboratory Tests. 2013: https://www.cancer.gov/about-cancer/diagnosis-staging/understanding-lab-tests-fact-sheet.

• National Cancer Institute. How Cancer Is Diagnosed. 2015: https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis.

• National Heart, Lung, and Blood Institute; National Institute of Health. Blood Tests. Bethesda, MD: US National Library of Medicine; https://www.nhlbi.nih.gov/health-topics/blood-tests.

• Nemours Foundation. KidsHealth: Blood Test – Complete Blood Count. Nemours Foundation; 2011.

Why Is My Dog Or Cat’s Hematocrit (Hct) Low Or High? – Ron Hines’ Vetspace – 2nd Chance – The Animal Health Website

When Low = Anemia

Ron Hines DVM PhD

See What Normal Blood & Urine Values Are

Causes Of Most Abnormal Blood & Urine Tests

See How Tests Are Grouped

The Causes Of Anemia 

Your Pet’s Hematocrit = Hct = PCV = Packed Cell Volume 

When your dog or cat’s blood is drawn up into a thin glass tube and then spun in a centrifuge, the height of the column of red cells that have spun to the bottom of the capillary tube is its hematocrit.  

Normally, about half of the tube then consists of the pet’s straw-colored blood serum at the top, with packed red blood cells at the bottom and a thin layer of white blood cells just above them (the buffy coat). If the red lower portion is anything less than about 40% of the total, your pet is anemic. The next test, blood hemoglobin content, measures the actual amount of the blood carrying element, hemoglobin, in your pet’s blood. Low hematocrits almost always lead to low hemoglobin levels. The only exception is when the fewer-than-normal red blood cells are larger than normal (a macrocytic anemia or MCV).

Reasons Why Your Pet Might Have A Low Hematocrit:

There are too many causes of anemia for me to mention. Here are some of the more common ones: Hemorrhage, including, hemorrhage into the intestinal tract (such as due to parvovirus infection in dogs or coccidiosis infection in kittens). Blood sucking parasites such as hookworms in dogs or in cats. Heavy flea infestation,

Other than blood loss through the intestines blood loss from wounds to the body or within the body after trauma is another common cause of a low PCV.

Blood parasites (such as haemobartonella/mycoplasmosis in cats or Babesiosis, ehrlichia and anaplasmosis in dogs) can be responsible for a low hematocrit.

Autoimmune anemias, where red blood cells are destroyed by antibodies generated by the pet’s own body is another fairly common cause of anemia in dogs.

Rupture of a major blood vessel, toxic bone marrow suppression, atypical responses to antibiotics and other medicines and bone marrow tumors can also be responsible for a low hematocrit.

In older dogs and cats, chronic kidney disease is a common cause of anemia. In those cases, toxins that build up suppress the formation of new red blood cells. That is called an aplastic anemia and a low reticulocyte count helps identify it. Chronic liver disease, malnutrition and vitamin/mineral deficiencies (B12,   Iron,   folate) can be responsible for a low hematocrit as well. Those deficiencies are often associated with the chronic intestinal inflammation present in diseases such as IBD (in your cat or in your dog).  Triad disease in cats and the intestinal form of lymphoma in cats also commonly lead to anemia.

Heavy tick and flea infestation can also be the cause of a low hematocrit and anemia. But anemia in parasitized pets is more likely to be caused by the blood parasites those ticks and fleas carry – compounded by the general stress that animals living in substandard conditions endure.

Reasons Why Your Dog And Cat Might Have A High Hematocrit:

The most common cause in dogs and cats is dehydration. Diarrhea and vomiting are the most common causes of dehydration. The second most common cause is probably a lack of interest in drinking due to ill health or the unavailability of water. Puppies and kittens are more susceptible to dehydration than mature pets. That is because of their higher metabolic rate.  

Persistent fever is another possible cause of dehydration. 

Diuretic medications such as furosemide (Lasix®) can cause dehydration as well.

On very rare occasions, your pet could actually be producing too many red blood cells (polycythemia). That rare condition can occur when kidney tumors produce erythropoietin (a stimulant to RBC production) or due to causes still unknown.

It is normal for greyhound dogs (and perhaps other sight hounds) to have high hematocrits. Polycythemia can also be a response to living at high altitudes or chronic lung disease – both of which limit your pet’s ability to absorb oxygen.

Complementary Tests:

CBC / WBC and blood chemistry panel, Paying particular attention to increased sodium  (as evidence of dehydration) MCV,    MCH and MCHC,   urinalysis,   reticulocyte count

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Hemogram with leukogram (B-CBC 5-diff, B-CBC 3-diff )

Hemogram with leukogram (B-CBC 5-diff, B-CBC 3-diff ) – SYNLAB Eesti

A hemogram is a comprehensive study in which the content of hemoglobin in the blood is measured, blood cells are counted: leukocytes, erythrocytes, platelets, and erythrocyte and platelet indices are calculated.

Leukogram with 5-component leukogram presented in absolute values:

• neutrophils
• eosinophils
• basophils
• lymphocytes
• monocytes

Leukogram with 3-component leukogram presented in absolute values:

• neutrophils
• lymphocytes
• MXD cells (monocytes, eosinophils, basophils)

Readings:

• Diagnosis of anemia. In addition to measuring hemoglobin and RBC levels, red blood evaluation also considers mean red cell volume (MCV), mean hemoglobin per erythrocyte (MCH), and mean hemoglobin concentration in erythrocyte (MCHC), as well as the red blood cell distribution index by volume (anisocytosis index RDW) .
• Determination of the presence of a pathological process based on changes in the number of leukocytes and in the leukogram, for example, infection, inflammation, allergy, malignancy, immunosuppression,.
• Determination of the platelet count is an important test in the presence of signs of bleeding. A change in the number of platelets, together with the indices characterizing them (MPV – mean platelet volume, PDW – platelet distribution width by volume) indicates a possible disturbance in platelet production or their accelerated destruction.

Analysis method: Flow cytometry

See table for reference values ​​

See table for critical values ​​

Interpretation of the result:

HEMOGLOBIN, HEMATOCRITE, RED CYTES

Normally, the values ​​of hemoglobin, hematocrit and erythrocytes are interconnected and change in the same direction.

• Low values: anemia
• High values: hypovolemia, polycythemia, chronic oxygen deficiency, smoking.

RBC INDICES: MCV, MCH, MCHC, RDW-CV

RBC indices characterize the morphological type of anemia.

Normocytic normochromic (MCV normal, MSI normal):

• Early stage iron deficiency
• Chronic disease (e.g. cancer)
• Acute blood loss
• Aplastic anemia
• Acquired hemolytic anemia (e.g. prosthetic heart valves)

Microcytic hypochromic (MCV ↓, MCH ↓):

• Advanced iron deficiency
• Thalassemia
• Lead poisoning

Microcytic normochromic (MCV ↓, MCH normal):

• Kidney disease (erythropoietin deficiency)

Macrocytic normochromic (MCV ↑, MCH normal):

• Folic acid or vitamin B12 deficiency
• Chemotherapy

Other possible causes of MCV ↑: pregnancy, certain drugs, alcohol.

With significant changes in MCV, it is necessary to evaluate the morphology of erythrocytes in the blood smear preparation.

RDW

Indicates Indicates the variability in the amount of erythrocytes (anisocytosis).

L LEUKOCYTES, LEUKOGRAM

• There are many possible causes of leukocytosis. More accurate information is given by an automatic 5-component leukogram of 5 types of leukocytes.
• A total white blood cell count that falls within the reference interval does not rule out abnormalities in different white blood cell populations.
• Neutrophilia – acute inflammation, toxic injury, immune disease, myeloproliferative disease.
• Eosinophilia – allergies, parasites, immune syndromes, malignant diseases (lymphoma, carcinoma).
• Basophilia – allergy, myeloproliferative diseases.
• Monocytosis – chronic inflammation, diseases occurring with tissue damage, chronic myeloproliferative diseases.
• Lymphocytosis – viral infections, reactive conditions, malignant lymphoproliferative diseases.
• Leukopenia – usually occurs from neutropenia. Occurs with viral infections, toxic (for example, drugs) or immune damage to the hematopoietic function, and with acute leukemia.

PLATELETS

• Thrombocytopenia most often occurs in connection with viral infections, the use of drugs, some autoimmune diseases, liver diseases, megaloblastic anemia, alcoholism, diseases of the hematopoietic system, hypersplenism.
• So-called pseudothrombocytopenia occurs when several aggregated platelets are counted by the analyzer as one large platelet.
  • This may be due to insufficient mixing of blood with anticoagulant after sample collection or platelet sensitivity to EDEDTA. In this case, to count the platelets, the test should be repeated by taking the blood into the citrate tube used for coagulation tests (with a blue stopper). Platelet aggregates are clearly visible by microscopic examination of a blood smear.
  • Thrombocytosis usually occurs in association with myeloproliferative disorders such as polycythemia and essential thrombocythemia and after splenectomy.
• Elevated platelet values ​​often occur together with reactive changes in leukocytes in bacterial infections.

PLATELET INDICES: MPV, PDW

MPV and PDW are important in clarifying the essence of the nature of thrombocytopenia and thrombocytosis.

• Elevated MRV and thrombocytopenia – indicates a normal regenerative ability of thrombocytopenia.
• Artifact MPV increase:
  • Long time between sample collection and analysis itself – platelets swell in blood sample cells EDTA
  • Platelet aggregates
• High PDW and MPV values ​​are a common finding in chronic myeloproliferative diseases.
• Increased PDW and decreased platelet count are common findings in megaloblastic anemias.
• Normal PDW and platelet count >500 × 109/L – often associated with reactive changes

Indications for blood smear microscopy

If the result of the absolute blood count is one If any of the following indicators are present in the hemogram, and if the analyzer reports atypical morphology, then blood smear microscopy is performed as a clarifying study.

Parameter	Hemogram with 3-component leukogram	Hemogram with 5-component leukogram
Erythrocytes	< 2.0 x 10 12 /L > 6.5 x 10 12 /L	< 2.0 x 1012/L > 6.5 x 1012/L
Hemoglobin	< 80 g/L > 200 g/L	< 80 g/L > 200 g/L
Leukocytes	< 1. 5 x 109/L > 15 x 109/L (> 2 l) > 20 x 109/L (< 2 l) ≤ 2 x 10 9 /L	< 1.5 x 109/L > 15 x 109/L (> 2 l) > 20 x 109/L (< 2 l) ≤ 2 x 10 9 /L
Neutrophils	< 1.0 x 109/L > 20 x 109/L	< 1.0 x 109/L > 20 x 109/L
Lymphocytes	< 0.8 x 109/L > 5.0 x 109/L (> 12 l) > 7.0 x 109/L (< 12 l)	< 0.8 x 109/L > 5.0 x 109/L (> 12 l) > 7.0 x 109/L (< 12 l)
Monocytes		> 1.5 x 109/L (> 12 l) > 3.0 x 109/L (< 12 l)
MXD cells (monocytes, eosinophils, basophils)	> 2 x 109/L (> 12 l) > 3.5 x 109/L (< 12 l)
Platelets	< 100 x 109/L > 1000 x 109/L	< 100 x 109/L > 1000 x 109/L

Clinical blood test (norm and deviations) in children and adults – World of Health

Let’s start with: “How and when to take a blood test?”

Here are some rules for donating blood:

• For this examination, capillary blood is used, which is taken from a finger. Less commonly, according to the doctor’s instructions, blood from a vein may be used.
• The analysis is carried out in the morning. The patient is forbidden to eat food, water 4 hours before taking a klinicheskii_analiz_kroviblood sample.
• The main medical supplies that are used for taking blood are a scarifier, cotton wool, alcohol.

Rules for collecting blood in medical institutions:

• The finger from which blood sampling is planned is treated with alcohol. For better blood sampling, it is useful to rub your finger first to ensure a better blood flow to it.
• The scarifier is used to pierce the skin on the finger.
• Blood is collected using a fine pipette. The sample is placed in a sterile tube.

Explanation of the main indicators of the general (clinical) blood test

Everyone in their life went through such a painless procedure as donating blood from a finger. But for the majority, the result remains only a set of numbers written down on paper. Explanations of this analysis will enable each patient to navigate the deviations that are detected in the blood, the reasons that caused them.

Hemoglobin

This blood component is a protein through which oxygen enters all internal organs / systems. The amount of this component is calculated in grams, which is in 1 liter of blood.

The norm of hemoglobin in the blood of children and adults.

This indicator will depend on the age of the patient, his sex:

• On the 1st day after birth: from 180 to 240.
• In the first month of life: 115-175.
• In the first six months: no more than 140, no less than 110.
• Up to 1 year: 110 to 135.
• 1 to 6 years old: no more than 140, no less than 110.
• In the age range of 7-12 years: no more than 145.
• Between 13-15 years: 115-150.
• From 16 years old (men): from 130 to 160.
• After 16 years (women): 120 to 140.

Increased hemoglobin:

1. Diagnosis of heart disease.
2. Diseases of the kidneys.
3. Heart/lung failure.
4. The patient has pathologies associated with hematopoiesis. Decreased hemoglobin:

1. Vitamin/iron deficiency.
2. Significant blood loss.
3. Blood cancer.
4. Anemia.
5. Rigid diet resulting in emaciation

Erythrocytes

Inside the components under consideration contains hemoglobin. The main purpose of erythrocytes is to carry oxygen to the internal organs. Often in the table, instead of the unit of measurement of erythrocytes, you can see the abbreviation RBC.

The norm of erythrocytes in the blood of children and adults.

The given figure must be multiplied by 1012. The result will be equal to the number of red blood cells that are present in 1 liter. blood:

• In newborns on the 1st day of life: not less than 4.3, not more than 7.6.
• In infants up to a month, this figure decreases: 3.8-5.6.
• 1-6 months: 3.5 to 4.8.
• Up to 1 year: not higher than 4.9, not lower than 3.6.
• 1 to 6 years: 3.5 to 4.5.
• In the age range of 7-12 years, the lower limit of the permissible norm increases to 4.7.
• In adolescence (up to the age of 15): 3.6-5.1.
• From 16 years of age (men): no more than 5.1, no less than 4.
• From 16 years old (women): from 3.7 to 4.7.

Causes of high and low red blood cells in children and adults.

Factors that provoke an increase / decrease in the number of red blood cells in the blood are similar to those that cause an increase / decrease in hemoglobin.

The distribution width of erythrocytes in the general blood test.

This parameter directly depends on the size of erythrocytes: if a large number of erythrocytes of different sizes are detected in a taken blood sample, one can speak of a high width of the distribution of erythrocytes.

The norm of the width of the distribution of erythrocytes in the blood in children and adults.

This indicator is identical for children, adults, and can vary from 11.5 to 14.5%.

Causes of increased and decreased erythrocyte distribution width in children and adults.

Deviation from the norm of the indicator under consideration may occur against the background of malnutrition, anemia, dehydration.

The average volume of erythrocytes in the general blood test.

This blood parameter helps to obtain information about the size of red blood cells. It is measured in femtoliters / micrometers cubed. This volume is calculated using a simple formula, for which you need to know the percentage of hematocrit, the number of red blood cells.

The distribution width of erythrocytes is the norm in children and adults.

Regardless of the age, sex of the patient, normally the considered blood parameter (MCV) should not be higher than 95 fl, not lower than 80 fl.

Causes of increased and decreased erythrocyte distribution width.

Decrease – often occurs due to lack of iron.

An increase in the MCV indicates a deficiency of certain trace elements.

Mean erythrocyte hemoglobin content

The resulting indicator (MCH) displays the amount of hemoglobin that is contained inside the 1st erythrocyte. It is calculated according to a certain formula, for which you need to know the amount of hemoglobin + erythrocytes. The specified parameter is measured in picograms. The MCH norm is the same for men, women, children: 24-33 pg.

Decrease – often due to iron deficiency anemia.

An increase in MCH is the result of a folic acid/vitamin B12 deficiency.

Average hemoglobin concentration in erythrocyte

The parameter in question (MCHC) is obtained by mathematical calculations using hemoglobin+hematocrit. The unit of measure is %. The norm of hemoglobin content in an erythrocyte varies within 30-38%.

Decline, causes:

1. Blood diseases.
2. Iron deficiency.

The probability of an increase in the indicator under consideration is small.

Erythrocyte sedimentation rate in the general blood test (ESR)

This indicator (ESR) is obtained by settling the taken blood sample. It is determined by the number, shape of red blood cells, measured in mm / h. The process under consideration is also influenced by the amount of proteins in the plasma.

The rate of erythrocyte sedimentation in the blood in children and adults.

This parameter does not change much with age, but there are differences:

• 1st day of life: 2-4.
• Babies up to a month: 4 to 8.
• Up to 6 months the ESR norm is 4-10.
• From 1 to 12 years: no more than 12, no less than 4.
• From 13 to 15 years, the lower limit of normal increases to 15.
• From 16 years old (men): 1-10.
• From 16 years old (women): 2-15.

Causes of increased and decreased erythrocyte sedimentation rate (ESR) in children and adults.

Increase, causes:

1. Infection of the organism.
2. Pregnancy.
3. Cancer.
4. Anemia.

Reduced ESR is the result of blood diseases.

Leukocytes

These are living cells of the body that are produced in the lymph nodes, bone marrow, and perform a controlling function. There are several varieties of blood components under consideration: neutrophils, monocytes, eosinophils, lymphocytes, basophils.

The norm of leukocytes children (adults):

The result will correspond to the percentage of leukocytes that are normally present in 1 liter of blood:

• On the 1st day of life: from 8. 5 to 24.5.
• In babies up to 1 month: from 6.6 to 13.8.
• In the first six months, the norm should not exceed 12.5, it cannot be less than 5.5.
• In the age range from 1 month. up to 1 year: 6 to 12% per liter of blood.
• 1 to 6 years old: no more than 12, no less than 5.
• Ages 7-12: 4.4 to 10.
• In adolescence (after the age of 15): not higher than 9.5, not lower than 4.4.
• From 16 years old (men/women): from 4 to 9.

Increase from the norm:

• Inflammatory phenomena in the body. This includes the postoperative period, ENT diseases, diseases of the lower respiratory tract, damage to the skin as a result of trauma / burns. With cancer, general blood testing will also show an elevated level of leukocytes.
• Pregnancy.
• Menstruation.
• Vaccination.

WBC reduction:

• Vitamin B12 deficiency.
• Diseases of the blood.
• A certain group of infectious diseases: malaria, viral hepatitis, typhoid fever.
• Effect of radiation.
• Systemic lupus erythematosus.
• Taking certain medications.
• Conditions in which immunodeficiency occurs.

Platelets in the general blood test

These are small non-nuclear cells, which contain trace elements, which ensure blood clotting.

The norm of platelets in the blood of children (adults):

The above figure must be multiplied by 109 .. The result will correspond to the number of cells that are normally present in 1 liter of blood:

• 1st day after birth: 180 -490.
• In children from 1 month. up to 1 year: not higher than 400, not lower than 180.
• 1 to 6 years: 160-390.
• In the age range of 7-12 years: not higher than 380, not lower than 160.
• In adolescence (up to 15 years inclusive): from 160 to 360.
• From 16 years old (men/women): from 180 to 320.

Causes of high and low platelets in children and adults.

Platelet increase, causes:

• Inflammatory reactions (including postoperative period).
• Oncological diseases.
• Significant blood loss.
• Diseases of the blood.

Decrease in platelets, causes:

• Defects in the functioning of the bone marrow.
• Cirrhosis of the liver.
• Blood transfusion.
• Immune system disorders.
• Diseases of the blood.

Hematocrit

By means of this parameter, the volume of erythrocytes is compared with the volume of blood. The unit of measure for hematocrit is percent.

Hematocrit, normal, children (adults)

With age, this parameter undergoes certain changes:

• On the 1st day after birth: 40-66%.
• In children up to a month: from 34 to 55%.
• In infants in the age range of 1-6 months: 32-43%.
• 1 to 9 years: 34-41%.
• From 9 to 15 years: 34-45%.
• From 16 years old (women): no more than 45%, no less than 35%.
• From 16 years old (men): 39-49%.

Hematocrit, increased:

• Heart/lung failure.
• Dehydrated.
• Some blood diseases.

Hematocrit, decrease:

• III-IV trimester of pregnancy.
• Anemia.
• Renal failure.

Granulocytes

This blood parameter is represented by several groups of cells: basophils, neutrophils, eosinophils. These granule bodies are indispensable participants in the fight against infections and microbes.

Granulocyte norm:

Absolute index . It will be referred to as GRA# on the blood test result tables. In this context, the rate of granulocytes can vary from 1.2 to 6.8 * 109 cells per 1 liter.

Percentage of granulocytes to leukocytes . Has the designation GRA%. The norm should not be more than 72%, less than 47%.

Causes of increased granulocytes:

• When inflammation occurs in the body, there is an increase in granulocytes in the blood.

Reasons for the decrease in granulocytes:

• Malfunctions of the bone marrow, which are associated with the production of blood cells.
• A patient is diagnosed with systemic lupus erythematosus.
• Taking certain medications.

Monocytes

Important components of the immune system. Their duties include the recognition of microorganisms dangerous to the body, the fight against inflammatory foci. Their number is limited.

The norm of monocytes in the blood of children and adults.

The given indicator (MON%) shows the percentage of monocytes in the total number of leukocytes:

• Babies up to and including 1 year old: 2-12%.
• From 1 to 15 years: not more than 10%, not less than 2%.
• From 16 years old (women/men): 2 to 9%.

Causes of increase and decrease in blood monocytes in children and adults.

Increase:

• Blood diseases.
• Systemic ailments.
• Infection of the body due to exposure to fungi, viruses, parasites.
• Chemical poisoning.

Reduction:

• Childbirth.
• Postoperative rehabilitation.
• Taking anticancer drugs.
• Inflammatory-purulent phenomena.

Neutrophils

These cells help the body cope with infections, eliminate its own extinct microparticles. According to their structure, they are divided into two groups: mature, immature.

The norm of neutrophils in the blood of children and adults.

This indicator displays the percentage of stab, segmented neutrovils in the total number of leukocytes. Consider the rate of stab in the blood in children, adults:

• On the 1st day after birth: 1-17%.
• In children from 1 month. up to 1 year: from 0.5 to 4%.
• Age group 1-12 years: 0.5-5%.
• From 13 to 15 years: not more than 6%, not less than 0.5.
• From 16 years old (women/men): 1-6%.

Indicators of the norm of segmented nuclei in the blood:

• In newborns on the 1st-3rd day of life: not more than 75-80%, not less than 45%.
• Babies from 1 month up to 1 year: from 15 to 45%.
• Age group 1-6 years: 25-60%.
• From 7 to 12 years old: no more than 66%, no less than 34%.
• In adolescence (up to 15 years inclusive.): 40-65%.
• 16 years old (female/male): 47-72%.

Increase in the number of neutrophils:

• Infection of the body.
• Oncological diseases.
• Vaccination.
• Inflammatory phenomena.

Decreased neutrophils:

• Treatment aimed at eliminating cancer: chemotherapy, medication. Taking other drugs that inhibit the protective capabilities of the body.
• Errors in the work of the bone marrow.
• Exposure.
• “Children’s” infectious diseases (rubella, measles, etc.).
• An excess of hormones that are produced by the thyroid gland.

Eosinophils

The next representatives of leukocytes. It is these cells that actively fight cancer cells, favor the cleansing of the body from toxins and parasites.

The norm of eosinophils in the blood of children and adults.

This indicator displays the percentage of eosinophils in the total number of leukocytes:

• On the 1st day of the baby’s life: 0. 5-6%.
• In the age range of 1 month-12 years: not more than 7%, not less than 0.5%.
• Age group 13-15 years: not more than 6%, not less than 0.5%.
• From 16 years old (women/men): 0 to 5%.

Reasons for the increase and decrease in eosinophils in children and adults.

Increased eosinophils:

• Pathologies of the hematopoietic system.
• Oncological diseases.
• Allergic conditions.
• Parasitic infestations.

Decreased eosinophils:

• Childbirth.
• Infection of the body (including the postoperative period).
• Chemical poisoning.

Basophils

When testing the blood, these cells may not be detected: the fewest elements of the immune system. They consist of microparticles, which provoke the occurrence of inflammatory phenomena in the tissues.