What is normocytic anemia. How is it different from other types of anemia. What causes normocytic anemia. What are the symptoms of normocytic anemia. How is normocytic anemia diagnosed. How is normocytic anemia treated. What is the prognosis for people with normocytic anemia.

Defining Normocytic Anemia: A Closer Look at Red Blood Cell Size and Count

Normocytic anemia is a blood disorder characterized by a low number of red blood cells that are of normal size. This condition differs from other types of anemia, such as microcytic anemia (small red blood cells) or macrocytic anemia (large red blood cells). To understand normocytic anemia better, it’s essential to first grasp the basics of red blood cells and their function in the body.

The Role of Red Blood Cells in the Human Body

Red blood cells, also known as erythrocytes, are the most abundant type of blood cell, making up 40-45% of blood volume. These cells play a crucial role in:

• Transporting oxygen from the lungs to body tissues
• Carrying carbon dioxide from tissues back to the lungs for expulsion
• Maintaining the body’s pH balance

The unique biconcave shape and lack of a nucleus allow red blood cells to be flexible and squeeze through even the smallest blood vessels. Their primary component, hemoglobin, is responsible for binding and transporting oxygen throughout the body.

How Does Normocytic Anemia Differ from Other Types of Anemia?

In normocytic anemia, the size of red blood cells remains normal, but their number is decreased. This distinguishes it from:

• Microcytic anemia: Small-sized red blood cells, often due to iron deficiency
• Macrocytic anemia: Larger-than-normal red blood cells, typically caused by vitamin B12 or folate deficiency

Understanding these differences is crucial for proper diagnosis and treatment of various types of anemia.

Etiology of Normocytic Anemia: Unraveling the Underlying Causes

Normocytic anemia can be either congenital (present at birth) or acquired (developed later in life). Identifying the root cause is essential for effective management and treatment.

Congenital Causes of Normocytic Anemia

Congenital normocytic anemia is often related to disorders that cause premature destruction or reduced production of red blood cells. Some examples include:

• Sickle cell disease
• Hereditary spherocytosis
• Thalassemia

Acquired Causes of Normocytic Anemia

Acquired normocytic anemia is more common and can result from various factors:

1. Chronic diseases: Kidney disease, cancer, rheumatoid arthritis, thyroiditis
2. Acute blood loss: Trauma, surgery, gastrointestinal bleeding
3. Bone marrow disorders: Aplastic anemia, myelodysplastic syndromes
4. Medications: Certain chemotherapy drugs, antiretroviral medications
5. Nutritional deficiencies: Early stages of iron, vitamin B12, or folate deficiency

Why do chronic diseases often lead to normocytic anemia? Chronic conditions can interfere with red blood cell production in the bone marrow or shorten the lifespan of existing red blood cells, leading to a gradual decrease in their number while maintaining normal size.

Recognizing the Signs and Symptoms of Normocytic Anemia

Normocytic anemia often develops slowly, and symptoms may be subtle at first. As the condition progresses, individuals may experience:

• Fatigue and weakness
• Pale skin
• Shortness of breath, especially during physical activity
• Dizziness or lightheadedness
• Rapid heartbeat or palpitations
• Chest pain
• Cold hands and feet
• Headaches

Can normocytic anemia symptoms vary in severity? Yes, the severity of symptoms can depend on the underlying cause, the rate at which anemia develops, and the individual’s overall health status. Sudden onset of anemia, such as from acute blood loss, may cause more pronounced symptoms compared to gradually developing anemia from chronic conditions.

Diagnostic Approaches: Identifying Normocytic Anemia and Its Underlying Causes

Accurate diagnosis of normocytic anemia involves a combination of clinical assessment, blood tests, and sometimes additional investigations to determine the root cause.

Initial Diagnostic Steps

The primary diagnostic tool for normocytic anemia is the complete blood count (CBC). This test provides crucial information about:

• Hemoglobin levels
• Red blood cell count
• Mean corpuscular volume (MCV) – to confirm normal cell size
• Other blood cell parameters

How does a CBC help diagnose normocytic anemia? A CBC showing low hemoglobin levels and red blood cell count, combined with a normal MCV (typically between 80-100 femtoliters), points towards normocytic anemia.

Further Investigations

Once normocytic anemia is confirmed, additional tests may be necessary to identify the underlying cause:

1. Reticulocyte count: To assess bone marrow response
2. Peripheral blood smear: To examine red blood cell morphology
3. Iron studies: To rule out iron deficiency
4. Vitamin B12 and folate levels: To exclude deficiencies
5. Kidney and liver function tests: To check for chronic diseases
6. Bone marrow biopsy: In cases of suspected bone marrow disorders

These tests help healthcare providers determine the most appropriate treatment approach.

Treatment Strategies for Normocytic Anemia: Addressing the Root Cause

The treatment of normocytic anemia primarily focuses on addressing the underlying condition causing the anemia. However, the approach may vary depending on the severity of symptoms and the specific etiology.

Treating the Underlying Condition

Addressing the root cause is often the most effective way to manage normocytic anemia. This may involve:

• Managing chronic diseases such as kidney disease or cancer
• Treating infections or inflammatory conditions
• Adjusting medications that may be contributing to anemia
• Addressing nutritional deficiencies, if present

Supportive Treatments

In some cases, additional treatments may be necessary to manage symptoms or boost red blood cell production:

1. Erythropoiesis-stimulating agents (ESAs): Medications like erythropoietin can stimulate bone marrow to produce more red blood cells
2. Blood transfusions: For severe anemia or acute symptoms
3. Iron supplementation: If iron deficiency is contributing to the anemia
4. Dietary changes: Ensuring adequate intake of iron, vitamin B12, and folate

Is iron supplementation always necessary in normocytic anemia? Not always. Unlike in iron-deficiency anemia, normocytic anemia doesn’t inherently indicate low iron levels. Iron supplementation should only be considered if iron deficiency is confirmed through testing.

Prognosis and Long-term Management of Normocytic Anemia

The outlook for individuals with normocytic anemia largely depends on the underlying cause and the effectiveness of treatment. In many cases, addressing the root cause can lead to significant improvement or resolution of the anemia.

Factors Affecting Prognosis

Several factors can influence the prognosis of normocytic anemia:

• The underlying condition and its treatability
• The severity of anemia at diagnosis
• The patient’s age and overall health status
• Adherence to treatment plans
• Response to therapy

Long-term Management Strategies

Effective long-term management of normocytic anemia often involves:

1. Regular monitoring of blood counts
2. Ongoing management of underlying chronic conditions
3. Lifestyle modifications, including a balanced diet and regular exercise
4. Avoiding triggers that may exacerbate anemia
5. Prompt treatment of infections or other acute illnesses

Can normocytic anemia recur after treatment? Yes, especially if the underlying condition is chronic or not fully resolved. Regular follow-ups and monitoring are crucial to detect and address any recurrence promptly.

Preventive Measures and Lifestyle Considerations for Normocytic Anemia

While not all cases of normocytic anemia can be prevented, certain lifestyle choices and preventive measures can reduce the risk or help manage the condition effectively.

Dietary Considerations

A balanced diet rich in essential nutrients can support overall health and potentially reduce the risk of anemia:

• Iron-rich foods: Lean meats, leafy greens, legumes
• Vitamin B12 sources: Eggs, dairy products, fortified cereals
• Folate-rich foods: Citrus fruits, beans, whole grains
• Vitamin C: To enhance iron absorption

Lifestyle Modifications

Certain lifestyle changes can complement medical treatment and improve overall health:

1. Regular exercise: To boost overall cardiovascular health
2. Stress management: Chronic stress can impact overall health and potentially exacerbate anemia
3. Adequate sleep: Essential for overall well-being and recovery
4. Avoiding excessive alcohol consumption: Which can interfere with red blood cell production
5. Quitting smoking: Smoking can affect oxygen levels in the blood

How does regular exercise benefit individuals with normocytic anemia? While it’s important to consult a healthcare provider before starting any exercise regimen, regular physical activity can improve cardiovascular fitness, enhance oxygen utilization, and potentially stimulate red blood cell production over time.

The Impact of Normocytic Anemia on Quality of Life and Daily Functioning

Normocytic anemia, especially when chronic or severe, can significantly impact an individual’s quality of life and daily functioning. Understanding these effects is crucial for comprehensive patient care and support.

Physical Impact

The physical effects of normocytic anemia can range from mild to severe:

• Reduced physical endurance and stamina
• Increased fatigue, affecting work and daily activities
• Decreased exercise tolerance
• Potential impact on cognitive function due to reduced oxygen supply to the brain

Psychological and Social Impact

The condition can also have psychological and social implications:

1. Mood changes, including irritability or depression
2. Anxiety related to the underlying condition or symptoms
3. Social isolation due to fatigue or reduced ability to participate in activities
4. Potential impact on work performance or educational pursuits

How can individuals cope with the psychological impact of normocytic anemia? Strategies may include joining support groups, seeking counseling, practicing stress-reduction techniques, and maintaining open communication with healthcare providers and loved ones about challenges and needs.

Adapting to Life with Normocytic Anemia

Living with normocytic anemia often requires adaptations to maintain quality of life:

• Pacing daily activities to manage energy levels
• Prioritizing tasks and seeking help when needed
• Maintaining a consistent sleep schedule
• Communicating limitations to family, friends, and employers
• Exploring accommodations at work or school if necessary

By understanding and addressing these various aspects of living with normocytic anemia, individuals can work towards maintaining a fulfilling and active life while managing their condition effectively.

Normocytic Anemia | AAFP

Am Fam Physician. 2000;62(10):2264

See related article on normocytic anemia.

What is normocytic anemia?

Normocytic anemia is a blood problem. It means you have normal-sized red blood cells, but you have a low number of them.

The presence of normal-sized red blood cells tells your doctor that you have normocytic anemia rather than another kind of anemia. For example, when anemia is caused by having too little iron in your diet, you have small red blood cells. When anemia is caused by having too little vitamin B₁₂, you have extra large red blood cells.

What causes normocytic anemia?

Normocytic anemia can be congenital (a problem you were born with) or acquired (caused by an infection or disease).

Congenital normocytic anemia is caused by the breaking up of red blood cells. Sickle cell disease is a congenital disorder of red blood cells.

The most common cause of the acquired form of normocytic anemia is a long-term (chronic) disease. Chronic diseases that can cause normocytic anemia include kidney disease, cancer, rheumatoid arthritis and thyroiditis. Some medicines can cause you to have normocytic anemia, but this does not happen often.

What are the signs of normocytic anemia?

Normocytic anemia usually starts slowly. It doesn’t have many signs at first. You may find yourself getting tired easily. You may look pale. If the anemia starts more suddenly or gets really bad, you might feel dizzy or weak.

How does my doctor find out that I have normocytic anemia?

Most often, normocytic anemia is found on routine tests that are part of a physical exam. It might be found on a blood test you get for some other reason. A complete blood count also called a CBC can show if you have normocytic anemia.

If your CBC shows a low number of normal-sized red blood cells, your doctor might want you to get more tests to see what is causing the anemia. If the cause is inherited, other family members may also need to be tested.

How is normocytic anemia treated?

When possible, fixing the condition that is causing the anemia is the most important part of treating it. This might mean you would stop taking a medicine, or your doctor might treat a chronic illness or look for something that causes you to lose blood.

If your normocytic anemia is very bad, you might get shots of erythropoietin (brand name: Epogen). Erythropoietin (say this: air-rith-ro-po-et-in) helps your bone marrow make more red blood cells. Talk to your doctor before you take extra iron pills or vitamins. Too much iron is not good for you either.

Components of Red Blood Cells and RBC Types

What are Red Blood Cells?

Red blood cells are a type of blood cell. Blood contains three types of cells: white blood cells, platelets, and red blood cells. These red blood cells, also called erythrocytes, are the most common blood cell type, accounting for 40–45% of the blood’s volume. They contain hemoglobin, which is a protein that carries oxygen throughout the body.

Red blood cells have a diameter of about 6 micrometers, making them larger than platelets and smaller than white blood cells. Their small size allows them to squeeze through even the smallest human blood vessels.

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What is the major function of red blood cells?

The role of human red blood cells is twofold: to transport oxygen from the lungs to the body’s tissues for cells to use and to transport carbon dioxide from the body’s tissues to the lungs for expulsion.

A protein called hemoglobin inside red blood cells is the transport molecule that allows red blood cells to carry oxygen throughout the body. It also has a characteristic red pigment, giving blood its red color.

What are the components of red blood cells?

Red blood cells contain hemoglobin and are covered with a membrane composed of proteins and lipids. Hemoglobin—an iron-rich protein that gives blood its red color—enables red blood cells to transport oxygen and carbon dioxide. Red blood cells do not have nuclei, allowing for more room for hemoglobin.

The shape of red blood cells is a unique biconcave shape (round with a flat, indented center). Their lack of nuclei makes them so flexible that they can pass through extremely small blood vessels.

Where are red blood cells produced?

The red blood cells of adult humans are produced in the bone marrow, which is the soft fatty tissue inside bones. In human embryos, they originate in the yolk sac and liver. From the bone marrow, blood circulates through the human body via the veins and arteries.

What stimulates red blood cell production?

In general, the production of red blood cells is controlled by erythropoietin, a hormone produced and released by the kidneys. Erythropoietin stimulates the production of red blood cells in the bone marrow.

The average adult human produces 2 to 3 million red blood cells every second, equating to about 200 billion red blood cells every day. Some conditions, such as a low oxygen content or red blood cell count, could trigger an increased production of erythropoietin.

How do red blood cells mature?

All blood cells (white, red, and platelets) are produced from stem cells called hemocytoblasts located in bone marrow. It takes about 7 days for a stem cell to fully mature into a red blood cell that is prepared to be released into the bloodstream.

During this process, the stem cell becomes an immature red blood cell called an erythroblast. Then, the nucleus and mitochondria of the erythroblast disappear, and the immature cell is gradually filled with hemoglobin. At this point, the cell is called a reticulocyte. Finally, the cell becomes a full mature red blood cell and enters the blood, ready to transport oxygen throughout the body.

How are old red blood cells removed from the body?

The life of a red blood cell is short due to its lack of nucleus; human red blood cells only survive for about 120 days. When red blood cells are old or damage, they are ready to be eliminated from the bloodstream.

Red blood cell removal is controlled by specialized cells called macrophages in the spleen (part of the lymphatic system) and the liver. The spleen disposes of worn-out red blood cells and controls the amount of blood cells at work in the body. Additionally, the liver recycles iron from damaged red blood cells. Together, the macrophages in the spleen and liver remove old red blood cells from the body.

What causes a low red blood cell count?

A low quantity of red blood cells can be caused by a variety of factors:

• Blood cancers (leukemia, lymphoma, and myeloma)
• Anemia
• Bone marrow failure
• Malnutrition
• Pregnancy
• Thyroid disorders
• Bleeding (internal and external)
• Hemolysis

Red blood cell count can also be reduced by certain drug interactions or nutritional deficiencies (iron, copper, vitamin B-6, vitamin B-12, or folate).

What diseases affect red blood cells?

While some red blood cell diseases can be caused by illnesses or nutritional deficiencies, others are inherited.

Diseases involving red blood cells include anemia (low red blood cell count or low hemoglobin), thalassemia (inherited blood disorders), and polycythemia vera or other blood cancers. Bone marrow disease and hypoxia (low blood oxygen levels) are also possibilities.

What is red blood cell isolation?

A red blood cell isolation protocol is a critical part of preparing a blood sample for analysis. Centrifugal force is used to isolate a cell population from other cells or to separate the components of a blood sample. As a result, the particles create distinct layers, making it easier to obtain a cell type.

What are the methods of red blood cell isolation?

There are a few different approaches to red blood cell isolation.

One method is selection. Positive selection is when red blood cells are targeted by the removal mechanism and retained for downstream analysis. On the other hand, negative selection is when other cell types are removed to leave the red blood cells untouched.

Red blood cell depletion is another approach, where a single cell type—in this case, red blood cell—is removed from a biological sample.

Is it possible to isolate DNA from red blood cells?

No. DNA is encased in the nucleus of cells, and red blood cells do not have nuclei. However, white blood cells carry DNA in their nuclei.

How do I remove contaminating red blood cells from my sample?

Akadeum’s revolutionary microbubble approach removes up to 99% of RBC contamination in a fast and easy workflow that maintains the health and physiology of delicate cells of interest. Simply mix to bind, spin to separate, and aspirate to discard.

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WHY MOVING erythrocytes have the shape of slippers

In the study of the human circulatory system, for a long time it remained unclear why the geometry of moving erythrocytes in thin vessels does not have symmetry (they resemble a slipper in shape). Numerical modeling of scientists from Morocco, the USA and France showed that the adoption of an asymmetric shape by erythrocytes compensates for the difference in speed between them and the external flow, thus ensuring the most efficient blood flow. The results of the work of scientists can be used to diagnose various diseases, such as malaria.

From the point of view of hydrodynamics, blood is a heterogeneous liquid: on average, 45% of it consists of red blood cells – erythrocytes, the rest is plasma, almost completely consisting of water; leukocytes (white blood cells), platelets and other blood elements occupy less than 1% in it. The main task of red blood cells is to transport oxygen to tissues. At rest, erythrocytes are a biconcave disk 6-8 µm in size with a membrane (elastic sheath) about 2 µm thick.

The complex structure of blood leads to the fact that the description of its dynamic characteristics is somewhat different from the description of traditional fluids. Despite this, scientists boldly use some tricks and simplifications from traditional hydrodynamics. Let’s take an example. In the most simple and general model of the circulatory system, the heart is a pump that creates a directed movement of blood in the “pipes”: arteries, veins and capillaries. It is generally accepted that the blood flow is laminar (that is, irrotational), while the velocity distribution profile inside the vessels is parabolic. The maximum flow velocity is observed on the axis of the vessel, in the middle, and at its edges the liquid is motionless. This simple form of flow is known in physics as the Poiseuille flow.

Of course, the study of the hydrodynamics of the circulatory system is not only theoretical. The applied aspect of these studies is no less important. After all, understanding the mechanisms that affect the efficiency of blood flow in the vessels should help prevent serious diseases, such as coronary heart disease.

One of these mechanisms has so far remained unclear. We are talking about the effect of plasma movement in small vessels (with a diameter only a few times greater than the characteristic size of erythrocytes) on the speed and shape of red blood cells, and vice versa. In particular, why is the shape of erythrocytes often asymmetrical even when plasma flow is described as Poiseuille flow? After all, it would be logical to assume that a symmetrical flow profile should also determine the symmetrical shape of red blood cells. Studies show that, indeed, part of the erythrocytes, when moving through the vessels, has a parachute-like appearance, that is, it has symmetry. However, other erythrocytes distort their regular shape, become asymmetrical and resemble a slipper-like shape. What and why makes erythrocytes so transformed?

A group of scientists from Morocco, the USA and France managed to answer this question. The results of their theoretical research are published in the journal Physical Review Letters in the article Why Do Red Blood Cells Have Asymmetric Shapes Even in a Symmetric Flow?

The authors of the article guessed that in order to determine the type of moving red blood cells, it is necessary to calculate the magnitude and direction of the velocity of each point of their elastic (subject to deformation from the side of the plasma flow) shell. In order to simplify, they reduced the solution of this problem to a 2D case, considering an erythrocyte as a two-dimensional figure and considering a two-dimensional blood flow. Of course, such a step of scientists causes some distrust, but, in the end, they obtained a plausible result, which means that this approximation justifies itself.

By writing down the corresponding equations and then solving them, the researchers found that the main parameter that determines the shape of erythrocytes is the reduction parameter ν , that is, the ratio of the area of ​​the erythrocyte to the area of ​​a circle that has the same perimeter as the figure of the red blood cell. Scientists have proved that below a certain critical value ν _kr the symmetrical appearance of erythrocytes loses its stability under the action of the external plasma flow and turns into an asymmetric, slipper-shaped one.

Here are some details of the numerical simulation. If we take the maximum blood flow rate of 800 µm/s (typical value in a small vein), the radius of the vessel is taken to be 10 times larger than the characteristic size of erythrocytes (approximately 60-80 µm), the plasma viscosity is equated to the viscosity of ordinary water, and also considered that the membrane stiffness is known and equal to 10 ^-19 J, then ν _kr will be 0.7. Consequently, erythrocytes with a decrease parameter greater than 0.7, which are not even on the axis of the vessel, migrate to the middle of the “pipe” and retain the symmetrical shape of the parachutes, which is resistant to any kind of perturbation. But as soon as the decrease parameter becomes less than 0.7, the shape of the erythrocyte becomes unstable, and it takes the form of a slipper.

This is how the mathematical criterion for the transformation of erythrocytes from a symmetrical form into an asymmetric one looks like. The physical reason, which dictates an asymmetric shape to the erythrocyte, is the delay in the speed of the red blood cell in relation to the external flow of the plasma. Let us assume that a parachute-shaped erythrocyte moves in the vessel with ν less than the critical value. According to calculations, as it moves in the vessel, the difference in speeds between the external flow of blood and the speed of the red blood cell itself will increase. The increasing velocity difference leads to membrane instability and to a decrease in the efficiency of the passage of erythrocytes in the vessel – red blood cells begin to “slow down”. For the circulatory system, the only way to compensate for the difference in velocities is to change the shape of the erythrocyte shell. All the same numerical modeling states that the best way would be for the red blood cells to adopt an asymmetrical shape – the shape of a slipper. As a result, the difference in speeds decreases, and the slipper-shaped shell becomes dominant for the erythrocyte.

Of course, different vessels have different widths, as well as the speed of blood flow in them, so the authors analyzed all possible realistic data by constructing a phase diagram of the transition of erythrocytes from a symmetrical form to an asymmetric one for a given vessel width (the ratio of the vessel radius to the characteristic size of an erythrocyte was equal to 10).

As we can see, for each current velocity value there is its own critical value of the reduction parameter ν _kr . Interestingly, the cytoskeleton (internal structure) of erythrocytes, as shown by the authors of the article, does not have any effect on their transition from a parachute shape to a slipper shape.

In their research, scientists have come to another important result. In medicine, it is known that some diseases, such as malaria, lead to a loss of elasticity of red blood cell membranes. Does this affect the appearance of the erythrocyte? It turns out yes. The researchers found that an increase in the rigidity of the shell by two or more times leads to a significant change in the shape of red blood cells – their “symmetrization” is observed.

According to the authors, this result can be used in the diagnosis of various pathologies of the circulatory system.

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Take a general clinical blood test with ESR and leukocyte formula price in the Moscow region

In the medical company “LabQuest” you can get a personal consultation with a doctor of the “Doctor Q” service on deciphering the results of a blood test at the time of admission or by phone.

It must be remembered that the interpretation of the results of a general blood test should be carried out only by a doctor, since the results of laboratory tests are not the only criterion for making a diagnosis and prescribing appropriate treatment. They should be considered in conjunction with the history data and the results of other possible examinations, including instrumental diagnostic methods.

ESR is a non-specific indicator of the inflammatory process. The level of ESR depends on physiological and pathological factors. It increases with inflammatory processes, intoxications, tumors, infections (acute and chronic), paraproteinemia, hepatitis, amyloidosis, tuberculosis, etc. The level of ESR decreases with an increase in the number of red blood cells (erythremia, erythrocytosis).

Red blood cells (RBCs) are red blood cells that contain the protein hemoglobin. The average lifespan of erythrocytes is 110-130 days. The main function of red blood cells is to carry oxygen from the lungs to other organs and tissues. An increase in the number of red blood cells (erythrocytosis) occurs with tissue hypoxia, polycystic kidney disease, renal artery stenosis, hydronephrosis, tumors, etc. A decrease in the number of red blood cells (erythrocytopenia) occurs after blood loss, with anemia, after radiation exposure, with increased breakdown of red blood cells, with diseases of the kidneys and liver, against the background of infectious diseases.

Hemoglobin (Hb) increases with dehydration, with an increase in the number of red blood cells. The concentration of hemoglobin decreases with anemia and with hyperhydration.

Hematocrit (HCT) is an indicator that is determined by calculating the ratio of the volume of red blood cells to the volume of the liquid part of the blood. Hematocrit increases with an increase in the number of red blood cells, with burn disease and dehydration of the body. HCT decreases with anemia, overhydration, pregnancy.

Mean cell volume (MCV) is a measure of the average volume of the entire population of red blood cells. According to this indicator, the doctor determines the type of anemia (normocytic, microcytic and macrocytic). A decrease in MCV is more common in iron deficiency anemia, and an increase in B12 deficiency anemia or folate deficiency anemia.

Mean erythrocyte hemoglobin (MCH) is an indicator of the average content of hemoglobin protein in 1 erythrocyte. Analogue of the obsolete color index (CPU). According to this indicator, the doctor divides anemia into normochromic, hypochromic and hyperchromic. MCH decreases with iron deficiency anemia, porphyria, and increases with macrocytic anemia.

Average concentration of hemoglobin in erythrocytes (MCHC) – the indicator reflects the saturation of erythrocytes with hemoglobin. MCHC increases with spherocytosis, cold agglutination of erythrocytes, after chemotherapy, decreases with hemoglobinopathies, anemia of chronic disease, iron deficiency anemia.

Distribution of erythrocytes by volume (RDW CV) – the indicator reflects the degree of anisocytosis of erythrocytes (change in the size of an erythrocyte). An increase in RDW occurs with a combination of red blood cells of different sizes (for example, normocytes and microcytes).

Platelets (PLT) are nuclear-free small blood cells that are involved in the formation of blood clots in normal conditions (in case of damage to the vessel) and in pathology (when an atherosclerotic plaque is “opened”). The number of platelets increases with increased physical exertion, after surgical interventions, against the background of oncological diseases, in acute and chronic inflammatory processes in the body. A decrease in the number of platelets occurs with bacterial and viral infections, pregnancy, enlarged spleen, autoimmune diseases, etc.

Mean platelet volume (MPV) is a measure of the average volume of the entire population of platelets. An increase in MPV is observed in patients with idiopathic thrombocytopenic purpura, hyperthyroidism, diabetes mellitus, smokers, and alcohol abuse. The indicator decreases after removal of the spleen, with ulcerative colitis and Crohn’s disease.

Leukocytes (WBC) are blood cells that are part of cellular immunity. The main function is to attack pathogenic microorganisms (bacteria, viruses, fungi) that have entered the body and remove the remains of cells after their destruction. Leukocytes include neutrophils, eosinophils, lymphocytes, monocytes, and basophils. An increase in leukocytes occurs normally after exercise, physiotherapy, against the background of pain of a different nature (for example, with a headache), after eating, emotional stress, exposure to cold and heat. The increase in leukocytes in these conditions is temporary and is called physiological (redistributive) leukocytosis. A pathological increase in leukocytes will be observed with angina, scarlet fever, otitis media, pneumonia, pyelonephritis, abscess, burns, injuries, malignant neoplasms, etc.

Neutrophils are the largest group of cells among leukocytes (60-70%). In the bloodstream, most of the neutrophils occupy the parietal position (marginal pool), and a small part remains in free circulation in the vessels (circulating pool). Neutrophils circulate in the blood for 8-10 hours, and then go into the tissues. The main function of neutrophils is to fight microbes that have entered the body. Neutrophils contain a large number of substances (bactericidal proteins) that can destroy almost all microorganisms. More often, neutrophils increase with pneumonia, cholecystitis, meningitis, sepsis, osteomyelitis, food poisoning, diphtheria, scarlet fever and other acute bacterial infections. A decrease in the number of neutrophils occurs in aplastic and megaloblastic anemia, acute leukemia, chronic lymphocytic leukemia, typhoid fever, brucellosis, tularemia, severe infectious diseases, SARS, influenza, starvation, prolonged stress, in newborns, etc.

Eosinophils – make up a small part of the cells among leukocytes (0.5-5%). They circulate in the bloodstream for 6-12 hours, then go to the tissues, mainly to the respiratory tract, the digestive system and the urinary tract. Eosinophil granules contain cationic protein, bactericidal peroxides and a number of other biologically active substances that have anthelmintic and antiparasitic protection, and also reduce the hypersensitivity reaction in allergies. With an allergic reaction in the KLA, the number of eosinophils first decreases, as they rush to the lesion, then the bone marrow begins to produce them in a larger number, therefore, after a while, they will normalize in the blood test and then the number will increase ( eosinophilia). Most often, eosinophils increase in bronchial asthma, food allergies, atopic eczema, helminthiases, autoimmune processes, malignant neoplasms, tuberculosis, psoriasis, herpes, fungal infections and inflammatory diseases (mononucleosis, scarlet fever, gonorrhea). A decrease in the number of eosinophils occurs at the initial stage of the inflammatory process, with severe purulent infections, shock, stress, heavy metal poisoning

Basophils – just like other leukocytes, they stay in the bloodstream for a short period of time (6 hours) and go into the tissues. Basophils contain histamine, enzymes, platelet activating factor, interleukins and other active substances that are involved in inflammatory reactions. An increase in the number of basophils occurs with allergic reactions, erythremia, chronic myeloid leukemia.

Monocytes are a small group of white blood cells that can engulf pathogens and broken cell debris. Approximately one hour after capture, most pathogens die inside the monocyte. An increase in the number of monocytes occurs in tuberculosis, malaria, brucellosis, sarcoidosis, syphilis, in the recovery period after acute infections, in chronic infections (tuberculosis, syphilis, sarcoidosis), in systemic lupus erythematosus, rheumatoid arthritis, etc.