Why would hct be low. Low Hematocrit Levels: Causes, Symptoms, and Treatment Options

03.01.197013.06.2021 by alexxlab

What are the common causes of low hematocrit levels. How do symptoms manifest in individuals with low hematocrit. What treatment options are available for managing low hematocrit levels. Why is hematocrit an important health indicator. How does anemia relate to low hematocrit levels.

Содержание

Understanding Hematocrit: A Key Indicator of Blood Health

Hematocrit is a crucial measure of blood health, representing the percentage of red blood cells in a person’s total blood volume. For instance, if 100 milliliters of blood contains 50 milliliters of red blood cells, the hematocrit level would be 50%. These cells are vital for transporting oxygen throughout the body, giving blood its characteristic red color.

Red blood cells contain hemoglobin, a protein that binds to oxygen molecules. This allows them to pick up oxygen from the lungs and deliver it to tissues and organs throughout the body. Maintaining an adequate amount of red blood cells is essential for the body’s processes to function smoothly.

Normal Hematocrit Ranges

Normal hematocrit levels vary depending on age and gender:

Adult men: 41-50%
Adult women: 36-48%
Children: 36-40%
Newborns: Higher levels that gradually decrease with age

It’s important to note that these ranges can be influenced by factors such as pregnancy, smoking, and certain medical conditions like chronic obstructive pulmonary disease (COPD).

Causes of Low Hematocrit Levels

Low hematocrit levels can be indicative of various health issues. Understanding the underlying causes is crucial for proper diagnosis and treatment.

Anemia: A Common Culprit

Anemia is a condition characterized by low hemoglobin levels, which often correlates with low hematocrit. There are several types of anemia, each with its own causes:

Iron-deficiency anemia: The most common type, often due to inadequate iron intake or absorption.
Vitamin B12 deficiency anemia: Caused by a lack of vitamin B12, which is essential for red blood cell production.
Folate deficiency anemia: Results from insufficient folate (vitamin B9) in the diet.
Aplastic anemia: A rare condition where the bone marrow fails to produce enough blood cells.

Chronic Blood Loss

Ongoing blood loss can lead to low hematocrit levels. Common sources include:

Gastrointestinal bleeding: Often due to ulcers or chronic use of non-steroidal anti-inflammatory drugs (NSAIDs)
Heavy menstrual bleeding: A common cause in women of reproductive age
Chronic nosebleeds
Hemophilia or other bleeding disorders

Bone Marrow Disorders

The bone marrow is responsible for producing red blood cells. Disorders affecting the bone marrow can result in low hematocrit levels:

Leukemia: A cancer of blood-forming tissues, including bone marrow
Lymphoma: Cancer that begins in infection-fighting cells of the immune system
Multiple myeloma: A cancer of plasma cells in the bone marrow
Myelodysplastic syndromes: A group of disorders characterized by dysfunctional blood cell production

Recognizing Symptoms of Low Hematocrit

Identifying the symptoms associated with low hematocrit levels is crucial for early detection and treatment. Common signs include:

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

These symptoms can vary in intensity depending on the severity of the condition and its underlying cause. It’s important to consult a healthcare provider if you experience persistent symptoms.

Diagnostic Procedures for Low Hematocrit

When low hematocrit levels are suspected, healthcare providers typically employ a range of diagnostic procedures to determine the underlying cause and severity of the condition.

Complete Blood Count (CBC)

A CBC is the primary test used to assess hematocrit levels. This comprehensive test includes:

Red blood cell count
White blood cell count
Platelet count
Hemoglobin levels
Mean corpuscular volume (MCV)
Red cell distribution width (RDW)

The CBC provides valuable information about the overall health of the blood and can help identify various blood disorders.

Peripheral Blood Smear

This test involves examining a sample of blood under a microscope to evaluate the size, shape, and appearance of blood cells. It can help identify abnormalities that may be causing low hematocrit levels.

Iron Studies

If iron-deficiency anemia is suspected, additional tests may be performed to assess iron levels in the body:

Serum iron
Total iron-binding capacity (TIBC)
Ferritin levels

Bone Marrow Biopsy

In cases where a bone marrow disorder is suspected, a bone marrow biopsy may be necessary. This procedure involves removing a small sample of bone marrow for examination under a microscope.

Treatment Approaches for Low Hematocrit

The treatment for low hematocrit levels depends on the underlying cause and severity of the condition. Here are some common approaches:

Nutritional Supplementation

For cases of nutrient deficiency anemia, supplementation may be recommended:

Iron supplements for iron-deficiency anemia
Vitamin B12 injections or supplements for B12 deficiency
Folic acid supplements for folate deficiency

Dietary changes may also be advised to increase the intake of these essential nutrients through food sources.

Medications

Various medications can be prescribed to address low hematocrit levels:

Erythropoiesis-stimulating agents (ESAs) to stimulate red blood cell production
Immunosuppressants for certain types of anemia caused by autoimmune disorders
Antibiotics to treat infections that may be causing anemia

Blood Transfusions

In severe cases or when rapid improvement is necessary, blood transfusions may be administered to quickly increase red blood cell levels.

Treatment of Underlying Conditions

Addressing the root cause of low hematocrit is crucial for long-term management. This may involve:

Treatment of gastrointestinal bleeding
Management of heavy menstrual bleeding
Chemotherapy or radiation therapy for blood cancers
Bone marrow transplant for certain bone marrow disorders

Lifestyle Modifications to Support Healthy Hematocrit Levels

While medical treatments are often necessary, certain lifestyle changes can help support healthy hematocrit levels:

Dietary Adjustments

Incorporating iron-rich foods into the diet can help prevent iron-deficiency anemia:

Lean meats and poultry
Fish
Beans and lentils
Dark, leafy greens
Fortified cereals

Consuming vitamin C-rich foods alongside iron-rich foods can enhance iron absorption.

Regular Exercise

Moderate exercise can stimulate red blood cell production. However, it’s important to consult with a healthcare provider before starting any new exercise regimen, especially if you have low hematocrit levels.

Hydration

Maintaining proper hydration is crucial for overall blood health. Dehydration can artificially elevate hematocrit levels, leading to inaccurate test results.

Stress Management

Chronic stress can negatively impact overall health, including blood cell production. Incorporating stress-reduction techniques such as meditation, yoga, or deep breathing exercises can be beneficial.

Potential Complications of Untreated Low Hematocrit

If left untreated, persistently low hematocrit levels can lead to various complications:

Cardiovascular Issues

The heart may need to work harder to pump oxygen-rich blood throughout the body, potentially leading to:

Irregular heartbeat (arrhythmia)
Enlarged heart (cardiomegaly)
Heart failure

Cognitive Impairment

Reduced oxygen supply to the brain can result in:

Difficulty concentrating
Memory problems
Impaired decision-making abilities

Pregnancy Complications

In pregnant women, low hematocrit levels can increase the risk of:

Preterm delivery
Low birth weight
Postpartum depression

Reduced Quality of Life

Chronic fatigue and weakness associated with low hematocrit can significantly impact daily activities and overall quality of life.

Prevention Strategies for Maintaining Healthy Hematocrit Levels

While some causes of low hematocrit are beyond our control, there are several preventive measures that can help maintain healthy levels:

Regular Health Check-ups

Routine blood tests can help detect changes in hematocrit levels early, allowing for prompt intervention if necessary.

Balanced Diet

Consuming a varied diet rich in iron, vitamin B12, and folate can support healthy red blood cell production. Consider including:

Lean meats
Fish
Eggs
Leafy green vegetables
Fortified cereals
Legumes

Supplementation When Necessary

In cases where dietary intake is insufficient, supplements may be recommended under medical supervision.

Avoid Excessive Alcohol Consumption

Heavy alcohol use can interfere with red blood cell production and accelerate the breakdown of existing red blood cells.

Quit Smoking

Smoking can damage red blood cells and impair their ability to carry oxygen efficiently.

Manage Chronic Conditions

Proper management of conditions such as diabetes, kidney disease, or autoimmune disorders can help prevent complications that may affect hematocrit levels.

By understanding the importance of hematocrit levels and implementing these preventive strategies, individuals can take proactive steps towards maintaining optimal blood health and overall well-being.

Definition, low levels, high levels, and more

Hematocrit is the percentage of red blood cells in a person’s blood. Low red blood cell levels indicate conditions such as anemia. High red blood cell levels could signal polycythemia, which can increase a person’s chance of developing a blood clot.

If a person feels tired, dizzy, or short of breath, a doctor may want to test their hematocrit levels to see if those levels fall into a normal range or not.

Both high and low hematocrit levels can be detrimental to a person’s health, and can result from a variety of conditions and lifestyle factors.

Read on to learn more about what this measure of red blood cell volume means, symptoms of abnormal levels, and what low and high levels might indicate.

Hematocrit is a measure of the percentage of red blood cells in the body. For example: if a person has 50 milliliters (ml) of red blood cells in 100 ml of blood, their hematocrit level is 50%.

Red blood cells transport oxygen around the body and give blood its characteristic red color. In addition to oxygen, they also contain hemoglobin, a protein that binds to oxygen molecules. This allows red blood cells to pick up hemoglobin from the lungs and deliver it throughout the body.

Having an adequate amount of red blood cells is essential to keep the body’s processes running smoothly.

However, the percentage of red blood cells in someone’s blood can change depending on a variety of lifestyle factors and even environmental changes. According to research, red blood cell counts tend to increase at high altitude.

Exercise, particularly strength training, may also affect hematocrit levels. A 2018 study found that females who participated in 16 weeks of strength exercise had lower levels at the end compared when they started. However, the study had a small sample size of 26 middle-aged, sedentary Turkish women. This means that these findings aren’t necessarily representative of a wider population.

There are many conditions that can affect red blood cell production or their life cycle. This can make it difficult for a medical professional to diagnose these conditions. A doctor will use a hematocrit test to confirm whether a person’s red blood cell count is affecting a health condition.

Doctors usually test hematocrit levels as part of a complete blood count (CBC).

A CBC is composed of a range of tests, and may include:

red blood cell count
reticulocyte count (young red blood cells)
an analysis of hemoglobin levels
an analysis of red blood cells, including size and shape
white blood cell tests
platelet tests

A doctor will also take into consideration a person’s sex, race, and age. It is important to note that certain blood-related conditions, such as sickle-cell anemia, affect particular demographic groups at higher rates.

Learn more about sickle cell anemia in African Americans here.

Dehydration can raise hematocrit levels, so this test is useful if a doctor suspects severe dehydration is the cause of a person’s symptoms.

A doctor may request frequent hematocrit tests to monitor the effect of chemotherapy on person’s bone marrow.

Normal hematocrit levels are:

Newborn babies have high hematocrit levels that gradually decrease as they get older.

If a person has recently received a blood transfusion, it may affect their results. Additionally, pregnant individuals may have lower levels than usual because the body increases its blood volume during pregnancy.

Other factors may push levels into a higher range, such as smoking and chronic obstructive pulmonary disease (COPD).

When a person has low hematocrit levels they tend to present with the following symptoms:

pale complexion
weakness
fatigue
low energy
trouble breathing
irregular heartbeat
cold hands or feet

These symptoms also indicate anemia, a condition where hemoglobin levels are lower than normal. Hemoglobin is a protein found in red blood cells that carries oxygen around the body.

Mild anemia is treatable, and it is particularly common in women. Severe anemia could signal a more serious underlying health condition that requires more extensive treatment.

Doctors associate anemia with several health conditions that include:

Nutrient deficiency

A person may lack B12, folate, or iron in their diet.

Learn more about how nutrient deficiency anemia is diagnosed and treated.

Chronic bleeding

This commonly occurs due to digestive tract ulcers, which are sores caused by the bacteria H.pylori or chronic use of anti-inflammatory medications such as ibuprofen, other non-steroidal anti-inflammatory drugs (NSAIDs), and aspirin. Many women also experience excessive blood loss from heavy menstrual bleeding.

Bone marrow disorder

This includes aplastic anemia, which damages stem cells in bone marrow.

Cancer

These are cancers that spread to bone marrow, such as leukemia and lymphoma.

Learn more about bone marrow cancers here.

Kidney failure

Kidney disease can lower the production of red blood cells, reducing hematocrit levels.

Thalassemia

When a person has this condition, their body does not produce enough hemoglobin.

Learn more about thalassemia here.

Sickle cell anemia

This condition changes the shape of red blood cells. These cells die earlier than normal, and they also clump together, which impairs blood flow.

Learn more about sickle cell anemia here.

Autoimmune disease

Conditions like rheumatoid arthritis and lupus may reduce red blood cell count.

Learn more about autoimmune diseases here.

When a person has high hematocrit levels they tend to present with these symptoms:

flushed skin
dizziness
vision problems
headaches
enlarged spleen

These symptoms signal polycythemia, a condition where the body produces too many red blood cells. This means blood is thicker and clots more easily.

Doctors cannot cure polycythemia, so treatment tends to focus on symptom management. The main goal is to avoid stroke and deep vein thrombosis (DVT), which is a blood clot usually occurring in a deep vein in the leg.

In some cases, dehydration causes polycythemia. When a person does not drink enough, their plasma levels drop, and this increases the proportion of red blood cells in their blood volume. A person can lower their red blood cell count by rehydrating.

Some conditions that can cause high hematocrit levels include:

Lung or pulmonary disease

When the lungs cannot absorb oxygen effectively and oxygen levels drop, the body compensates by making more red blood cells. One common pulmonary disease causing this is COPD.

Learn more about COPD here.

Heart disease

If the structure of a person’s heart reduces its ability to pump blood around the body, it can no longer sustain vital organs with oxygen. To try and overcome the oxygen deficit the body produces more red blood cells.

Learn more about heart disease here.

Kidney cancer

Sometimes kidney cancer cells create more erythropoietin. Erythropoietin is a hormone that tells the bone marrow to create more red blood cells.

Learn more about kidney cancer here.

Genetic disease

The JAK2 gene, which controls the number of blood cells made in the bone marrow, can affect certain conditions. When someone has a mutated JAK2 gene, the body could make a protein that signals the bone marrow to create more red blood cells than it needs.

Learn more about genetic disorders here.

A person should speak with a doctor if they are experiencing any of the symptoms listed above that could be a sign of high or low hematocrit levels, including fatigue, weakness, vision problems, and dizziness.

These symptoms can also indicate an underlying condition, so it is important that a person contact a doctor in a timely manner to prevent future complications.

If a person is receiving chemotherapy treatment, a doctor should perform regular hematocrit tests to monitor bone marrow health.

Hematocrit is the percentage of blood cells in a person’s blood volume. A doctor may choose to test an individual’s hematocrit level due to certain symptoms.

A low hematocrit level means the are too few red blood cells in the body. In these cases, a person may experience symptoms that signal anemia. Common symptoms include fatigue, weakness, and low energy.

If a person has too many red blood cells, they have a high hematocrit level. A person may experience dizziness and headaches, which can be a sign of the condition polycythemia.

Demographic and lifestyle factors can influence a person’s hematocrit levels. For example, males tend to have higher levels than females. Pregnant individuals can experience a decrease in hematocrit levels, and strength training may also reduce levels.

There are also a number of health conditions that can cause hematocrit levels outside the normal range. Excessive bleeding, thalassemia, and kidney disease are causes of low levels. COPD and sickle cell anemia can cause high levels.

Definition, low levels, high levels, and more

If a person feels tired, dizzy, or short of breath, a doctor may want to test their hematocrit levels to see if those levels fall into a normal range or not.

Both high and low hematocrit levels can be detrimental to a person’s health, and can result from a variety of conditions and lifestyle factors.

Read on to learn more about what this measure of red blood cell volume means, symptoms of abnormal levels, and what low and high levels might indicate.

Hematocrit is a measure of the percentage of red blood cells in the body. For example: if a person has 50 milliliters (ml) of red blood cells in 100 ml of blood, their hematocrit level is 50%.

Having an adequate amount of red blood cells is essential to keep the body’s processes running smoothly.

Doctors usually test hematocrit levels as part of a complete blood count (CBC).

A CBC is composed of a range of tests, and may include:

red blood cell count
reticulocyte count (young red blood cells)
an analysis of hemoglobin levels
an analysis of red blood cells, including size and shape
white blood cell tests
platelet tests

Learn more about sickle cell anemia in African Americans here.

Dehydration can raise hematocrit levels, so this test is useful if a doctor suspects severe dehydration is the cause of a person’s symptoms.

A doctor may request frequent hematocrit tests to monitor the effect of chemotherapy on person’s bone marrow.

Normal hematocrit levels are:

Newborn babies have high hematocrit levels that gradually decrease as they get older.

Other factors may push levels into a higher range, such as smoking and chronic obstructive pulmonary disease (COPD).

When a person has low hematocrit levels they tend to present with the following symptoms:

pale complexion
weakness
fatigue
low energy
trouble breathing
irregular heartbeat
cold hands or feet

These symptoms also indicate anemia, a condition where hemoglobin levels are lower than normal. Hemoglobin is a protein found in red blood cells that carries oxygen around the body.

Mild anemia is treatable, and it is particularly common in women. Severe anemia could signal a more serious underlying health condition that requires more extensive treatment.

Doctors associate anemia with several health conditions that include:

Nutrient deficiency

A person may lack B12, folate, or iron in their diet.

Learn more about how nutrient deficiency anemia is diagnosed and treated.

Chronic bleeding

Bone marrow disorder

This includes aplastic anemia, which damages stem cells in bone marrow.

Cancer

These are cancers that spread to bone marrow, such as leukemia and lymphoma.

Learn more about bone marrow cancers here.

Kidney failure

Kidney disease can lower the production of red blood cells, reducing hematocrit levels.

Thalassemia

When a person has this condition, their body does not produce enough hemoglobin.

Learn more about thalassemia here.

Sickle cell anemia

This condition changes the shape of red blood cells. These cells die earlier than normal, and they also clump together, which impairs blood flow.

Learn more about sickle cell anemia here.

Autoimmune disease

Conditions like rheumatoid arthritis and lupus may reduce red blood cell count.

Learn more about autoimmune diseases here.

When a person has high hematocrit levels they tend to present with these symptoms:

flushed skin
dizziness
vision problems
headaches
enlarged spleen

These symptoms signal polycythemia, a condition where the body produces too many red blood cells. This means blood is thicker and clots more easily.

Some conditions that can cause high hematocrit levels include:

Lung or pulmonary disease

When the lungs cannot absorb oxygen effectively and oxygen levels drop, the body compensates by making more red blood cells. One common pulmonary disease causing this is COPD.

Learn more about COPD here.

Heart disease

Learn more about heart disease here.

Kidney cancer

Sometimes kidney cancer cells create more erythropoietin. Erythropoietin is a hormone that tells the bone marrow to create more red blood cells.

Learn more about kidney cancer here.

Genetic disease

Learn more about genetic disorders here.

These symptoms can also indicate an underlying condition, so it is important that a person contact a doctor in a timely manner to prevent future complications.

If a person is receiving chemotherapy treatment, a doctor should perform regular hematocrit tests to monitor bone marrow health.

Hematocrit is the percentage of blood cells in a person’s blood volume. A doctor may choose to test an individual’s hematocrit level due to certain symptoms.

If a person has too many red blood cells, they have a high hematocrit level. A person may experience dizziness and headaches, which can be a sign of the condition polycythemia.

9 common nutrient deficiencies in the U.S.

Although most of us are aware of the benefits of eating a balanced diet, nearly 10% of people in the U.S. have nutrient deficiencies. Failing to get key nutrients can lead to a variety of health problems, including fatigue, night blindness, osteoporosis, high blood pressure, and even acne.

If you’re experiencing the above symptoms and have ruled out other health conditions, you may suffer from a nutrient deficiency. Preventing and detecting the most common ones—including calcium, essential fatty acids, folic acid, iron, magnesium, and vitamins A, B12, C, and D—can be achieved through monitoring and adjusting your diet, considering dietary supplements, and having a conversation with your healthcare provider if you suspect you have a vitamin or mineral deficiency.

What is a nutrient deficiency, and how do I know if I have one?

“A nutrient deficiency occurs when a body doesn’t get the necessary amount of nutrients it needs (a nutrient being a substance that is essential for growth, development, or the maintenance of life),” says Michael Jay Nusbaum, MD, the medical and surgical director at Nusbaum Medical Centers in New Jersey.

Many people have vitamin deficiencies but never realize it. Those who maintain a poor diet, eat poor quality food, or fail to take supplements are most at risk. In many cases, symptoms lead to a patient getting testing, which reveals the deficiency.

Once a nutritional deficiency is detected, it’s treated by providing the nutrients needed in the diet either through food, supplements, or both. In some severe deficiency cases, IV infusions may be necessary to replenish what is missing, according to Dr. Nusbaum.

9 common nutrient deficiencies

In the U.S., calcium, essential fatty acids, folic acid, iron, magnesium, and vitamins A, B12, C, and D are some of the most common nutrient deficiencies.

1. Calcium

Calcium’s main reputation comes from being an important building block for strong bones. But the essential mineral is also key for nerve and muscle function and heart health. Because calcium is stored in the bones and withdrawn when we don’t consume enough, a calcium deficiency leaves bones weak and more likely to break.

Nearly 70% of Americans fail to meet the recommended daily intake for calcium, which is due to either inadequate intake of calcium-rich foods or to poor absorption. Additionally, caffeinated beverages, alcohol, soda, dark leafy greens, beans and whole grains can decrease the body’s absorption of calcium. Signs of a calcium deficiency include mottled teeth, weak fingernails, or a numbness/tingling in the fingers or muscle cramps.

2. Essential fatty acids

“Essential fatty acid deficiencies occur when omega-3 consumption is too low, but symptoms can also appear if omega-6 fatty acid intake from processed foods is too high,” says Paul Kriegler, RD, the nutritional products program manager at Life Time. Symptoms include scaly skin, brittle or cracking nails, and acne.

3. Folic acid

Folic acid, one of the many B vitamins, plays a role in maintaining healthy red blood cells and is particularly important during pregnancy, as women with low folic acid stores have a greater chance of having a baby with a neural tube defect (such as spina bifida). Outside of pregnancy, folic acid helps prevent anemia and heart disease.

Those who don’t consume enough fruits and vegetables (or who overcook their veggies) are at the greatest risk of developing a folate deficiency. People who consume high amounts of alcohol or who take certain medications (such as phenytoin, methotrexate, sulfasalazine, triamterene, trimethoprim-sulfamethoxazole, and barbiturates) have an increased risk of developing a folic acid deficiency. Symptoms may be similar to those caused by an iron deficiency, including fatigue, lethargy, hair loss, and shortness of breath.

RELATED: 3 types of medications that could have a vitamin interaction

4. Iron

“Iron deficiencies can occur multiple ways: inadequate consumption of iron-rich foods, poor iron absorption, or iron loss through excess blood loss or during developmental stages in life such as adolescence, pregnancy, or breastfeeding,” Kriegler says. Other people who have an increased risk of developing an iron deficiency include those with certain stomach or intestinal conditions that either cause bleeding or reduce the absorption of iron from food.

Iron deficiency anemia can cause general fatigue, headaches, dizziness, shortness of breath, muscle weakness, pale skin color, and chest pain. In pregnant women, iron levels should be routinely checked, as expectant mothers are at an increased risk of developing this condition.

5. Magnesium

Magnesium is an essential mineral that affects hundreds of metabolic reactions within the body, including regulating muscle and nerve function. “Many Americans don’t consistently consume adequate amounts of magnesium and most multivitamin supplements contain insufficient amounts of magnesium because it’s a bulky mineral that takes up a large volume of space in the formula, so it’s often recommended as an additional, stand-alone supplement,” notes Kriegler. Symptoms of a magnesium deficiency include muscle cramps, abnormal heart rhythms, unexplained numbness or tingling, and high blood pressure.

6. Vitamin A

Vitamin A is essential in the replacement of skin cells and for maintaining optimal vision and a healthy immune system. For this reason, those with a vitamin A deficiency are at an increased risk of acquiring a severe infection. As children are prone to infections, it’s crucial that those under the age of 5 get enough vitamin A in their diets or through supplements. In adults, one of the key warning signs of a vitamin A deficiency is night blindness.

7. Vitamin B12

One of the eight types of B vitamins, vitamin B12 helps to form red blood cells, enhances neurological function, and provides building blocks for DNA. Those most at risk for a vitamin B12 deficiency are vegans, people with intestinal problems that limit vitamin absorption, older adults, and those taking long-term heartburn medication. Symptoms of vitamin B12 deficiency are similar to those of anemia, including weakness, pale skin, shortness of breath, and mood changes.

8. Vitamin C

Vitamin C acts as an antioxidant within the body, helping to prevent damage inflicted by free radicals. Vitamin C also helps in hormone and amino acid formation; it also helps with the absorption of iron. The most commonly known effect of a vitamin C deficiency is scurvy, a fatal-if-untreated disease that causes inflamed and bleeding gums, easy bruising, weakness, fatigue, rashes, and difficulty healing wounds. While scurvy is uncommon today, proper vitamin C intake is still crucial for optimal health, as vitamin C regulates collagen production.

9. Vitamin D

Vitamin D is unique in that most vitamin D can be produced in our bodies when exposed to adequate amounts of UVB radiation from sunlight. Vitamin D’s key role is to regulate calcium absorption. Those with a vitamin D deficiency are unable to absorb that calcium and in turn strengthen bones. However, vitamin D has several other important roles for overall health, including supporting bone health, cardiovascular health, testosterone, and immune function.

The NIH says that “35% of adults in the United States are vitamin D deficient.” Try to get 10-15 minutes of mid-day sun exposure of the face, hands, and arms without protective sunscreen may be enough to maintain healthy vitamin D levels, depending on the time of year, latitude, and skin pigmentation characteristics. Remember, if your skin is starting to turn pink, you’ve gotten too much sun.

RELATED: How much vitamin D should I take?

How to prevent nutrient deficiencies

“The simplest way to prevent nutrient deficiencies is to eat a wholesome, nutrient-dense diet based on an abundance of produce (seven-plus servings per day) and ample protein, plus supplementing your diet every day with a high quality multivitamin, vitamin D, and omega-3 fish oil,” says Kriegler. If you’re concerned about a nutrient deficiency, there are a few steps you can take:

Get tested

Your healthcare provider can order a blood test to evaluate your essential nutrient levels if you’re exhibiting symptoms of a deficiency. An individual blood test can be conducted to assess a specific nutrient deficiency. However, a comprehensive nutrition panel is the most effective way to measure your overall health according to levels of vitamins, nutrients, and enzymes. Overnight fasting may be recommended to enhance the accuracy of results.

Evaluate your diet

Getting nutrients from your diet while avoiding processed foods, fast foods, and sugars is the ideal way to avoid a nutrient deficiency. Food sources include:

Calcium: Dairy products (milk, yogurt, or cheese), sardines, calcium-fortified orange juice, and dark green leafy vegetables
Folic acid: Eggs, leafy green vegetables, fruits, and dried beans and peas
Essential fatty acids: Cold water fish, flaxseed, and olive oil
Iron: Fortified dairy products, fatty fish, egg yolks, red meat, poultry, fish, and beans or legumes
Magnesium: Pumpkin seeds, leafy green vegetables, beans, legumes, and whole grains
Vitamin A: Spinach, chard, sweet potatoes, squash, pumpkins, carrots, mangoes, papayas, eggs and milk
Vitamin B12: Meat, fish, poultry, eggs, and dairy products
Vitamin C: Citrus fruits, broccoli, cantaloupe, cauliflower, kiwi, sweet potatoes, tomatoes, kale, bell peppers, and strawberries
Vitamin D: Fatty fish, beef liver, egg yolks, or a number of fortified foods (however, it’s almost impossible to achieve optimal vitamin D levels solely through diet, notes Kriegler)

Consider supplements

Even with a healthy diet, it can be difficult to achieve an optimal balance of nutrients. Supplements containing essential nutrients are available either alone, or in multivitamin formulas; your healthcare provider or pharmacist can help you determine the right balance of supplements.

Low Hemoglobin or Hematocrit – Cancer Therapy Advisor

Differential Diagnosis

Iron deficiency anemia
Thalassemia
Anemia of chronic disease
Acute blood loss
Lead poisoning
Anemia from folate or vitamin B12 deficiency
Sickle cell anemia
Hereditary spherocytosis or elliptocytosis
Hemoglobinopathies other than sickle cell disease
Autoimmune hemolytic anemia
Hemolytic disease of the newborn
Microangiopathic hemolytic anemia
Glucose-6-phosphate dehydrogenase (GGPD) deficiency
Pyruvate kinase deficiency
Paroxysmal nocturnal hemoglobinuria (PNH)
Sideroblastic anemia
Aplastic anemia

Don’t Miss – Dangerous Situations

Acute blood loss resulting in a rapid decrease in hemoglobin or hematocrit can be life-threatening. If not promptly treated, many of the listed disorders in the list can result in clinically severe and possibly lethal outcomes.

Commonly Encountered Situations

More commonly encountered anemias

Suggested Additional Lab Testing

Obtain hematocrit or hemoglobin measurement or RBC number to determine RBC mass.

Initial studies to assist in the evaluation of the type of anemia:

For the individual types of anemia, certain other tests are valuable in the diagnosis. These are listed in conjunction to the type of anemia.

Iron deficiency anemia

Microcytic hypochromic RBC with elliptocytes with a low reticulocyte production
Bone marrow deficient in iron is not usually needed to establish the diagnosis
Low serum ferritin, low serum iron, and elevated total iron binding capacity (TIBC) is typical.
Elevated RBC distribution width

Thalassemias

Microcytic RBCs with a variety of abnormalities on the peripheral smear, depending on the type of thalassemia and the clinical severity of the disease
Hemoglobin analysis may be abnormal and indicative of a certain type of thalassemia.
Patients with thalassemia often have normal to high serum ferritin, normal to low TIBC, normal to high serum iron, and normal RBC distribution width.

Anemia of chronic disease

RBCs are microcytic or normocytic, with an increase in size and shape variation.
Typical case: normal to elevated serum ferritin, low serum iron, low TIBC, increased sed rate

Anemia from acute blood loss

Anemia from folate or vitamin B12 deficiency

RBCs are macrocytic with macro-ovalocytes and low reticulocyte production.
For folate deficiency specifically, there is low or normal serum folate with low RBC folate and hypersegmented PMNs in peripheral blood smear.
For vitamin B12 deficiency, along with low serum vitamin B12, there may be elevated homocysteine and methylmalonic acid (MMA) levels indicative of pernicious anemia.
Anti-parietal cell antibodies and/or anti-intrinsic factor antibodies may be present in cases with pernicious anemia; hypersegmented PMNs can be found in the peripheral blood smear.

Sickle cell anemia

Sickle cells are found in sickle cell disease but not in sickle cell trait (under normal oxygen conditions).
Signs of hemolysis are found, including low haptoglobin, elevated unconjugated bilirubin, and increased LDH.
Hemoglobin analysis shows hemoglobin SS for sickle cell disease and hemoglobin AS for sickle cell trait.
Screening tests for the presence of sickle hemoglobin, usually based on the altered solubility of sickle hemoglobin, are positive in both sickle cell disease and sickle cell trait.

Anemias from hereditary spherocytosis or elliptocytosis

Reticulocyte production is high with the presence of spherocytes or elliptocytes and a prominent hemolytic component for hereditary spherocytosis in particular.
In hereditary spherocytosis, there is increased osmotic fragility of RBCs in the presence of a negative direct antiglobulin test.

Anemias from hemoglobinopathies other than sickle cell disease

Hemolytic disease of the newborn

Reticulocyte production index is high with a prominent hemolytic component: low haptoglobin, elevated unconjugated bilirubin, and elevated LDH.
Mother tests Rh negative and baby tests Rh positive, with a positive direct antiglobulin test on the RBCs of the baby and an antibody to offspring RBCs in the mother’s blood.

Microangiopathic hemolytic anemia

G6PD deficiency

Test for RBC G6PD shows a deficiency.

Pyruvate kinase deficiency

Reticulocyte production index is high, with a prominent hemolytic component.
An assay to quantitate RBC pyruvate kinase reveals the deficiency.

PNH

Prominent hemolytic component, with low platelet and WBC (especially granulocyte) counts
Flow cytometry of granulocytes and RBC showed decreased CD 55 and CD 59.
RBC populations in sideroblastic anemia are normochromic and hypochromic.
Increase in ringed sideroblasts in a normoblast population on bone marrow biopsy
Elevated serum ferritin

Aplastic anemia

No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.

Hematocrit – Complete Blood Count

Hematocrit

The hematocrit,
also known as the “Hct“, “crit”
or PCV (packed cell volume) determines the percentage of red
blood cells in the plasma. The term hematocrit means “to separate blood. ”
When the patient’s blood sample is spun in a centrifuge, the white blood cells
and platelets rise to the top in what is known as the “buffy coat.”
The heavier red blood cells sink to the bottom, where they can be calculated
as a percentage of the total blood sample.

Normal hematocrit values
are:

Newborn: up to
60%

Adults: (males):
40- 54%

(Females): 36
– 46%

Pregnancy: decreased
hematocrit, especially in the last trimester as
plasma volume increases

Children: varies
with age

If the RBC
and the hemoglobin are both normal, it is possible to estimate
the hematocrit as being approximately three times the hemoglobin. For example,
a person whose hematocrit is 30% would have a hemoglobin of approximately 10
gm.

Instant
Feedback:

Pregnant
women normally have a drop in hematocrit in the last trimester of pregnancy.

Because the hematocrit
is a percentage of red blood cells, as compared to the total volume of blood,
any increase or decrease in plasma volume affects the hematocrit.
A patient with a severe burn loses huge amounts of plasma from damaged capillaries.
As a result, the vascular space loses fluid in relation to cellular elements
and the patient’s hematocrit will be significantly increased.
A decreased hematocrit occurs due to overhydration, which lowers
the percentage of red blood cells in relation to the liquid plasma portion of
blood.

A hematocrit
is frequently done to assess the extent of significant blood loss. A hematocrit
that is done immediately after a hemorrhage usually does not show the extent
of RBC loss because at the time of the hemorrhage, plasma and red blood cells
are lost in equal proportions. However, within several hours after hemorrhage,
plasma volume increases due to a shift of interstitial fluid into the vascular
space. Red blood cells, however, cannot be replaced quickly, as the bone marrow
takes approximately ten days to produce mature red blood cells. As a result,
a hematocrit done several hours after a bleeding episode will
show a more accurate picture – the hematocrit will be decreased
because the plasma volume has compensated for fluid loss while the red blood
cells that have been lost cannot be replaced for days. It is important for the
nurse to remember that a hematocrit value must always be interpreted
in relation to the patient’s hydration status and to the time the sample was
drawn. When packed red blood cells are given to correct an anemia, the hematocrit
should rise approximately 3% for each unit transfused.

How a patient responds to
a low hematocrit depends on whether the blood loss is acute
or chronic. If a person with a normal blood cell volume loses blood suddenly
through a massive hemorrhage, the person may develop signs and symptoms of circulatory
shock; the blood pressure will fall and the patient will show signs of tissue
hypoxia and shock. However, a person with chronically low hemoglobin, such as
a patient on renal dialysis, may tolerate abnormally low hemoglobin. A major
reason for anemia in patients with renal failure is lack of erythropoetin to
stimulate bone marrow production.

Instant
Feedback:

Expect
a patient’s hematocrit to drop immediately after major hemorrhage.

Hematocrit: critical
low and high values:

A hematocrit
of less than 15% can result in cardiac failure

A hematocrit
of over 60% may result in spontaneous blood clotting

Hemoglobin and Hematocrit – Clinical Methods

Definition

Hemoglobin (Hb) is the protein contained in red blood cells that is responsible for delivery of oxygen to the tissues. To ensure adequate tissue oxygenation, a sufficient hemoglobin level must be maintained. The amount of hemoglobin in whole blood is expressed in grams per deciliter (g/dl). The normal Hb level for males is 14 to 18 g/dl; that for females is 12 to 16 g/dl. When the hemoglobin level is low, the patient has anemia. An erythrocytosis is the consequence of too many red cells; this results in hemoglobin levels above normal.

The hematocrit measures the volume of red blood cells compared to the total blood volume (red blood cells and plasma). The normal hematocrit for men is 40 to 54%; for women it is 36 to 48%. This value can be determined directly by microhematocrit centrifugation or calculated indirectly. Automated cell counters calculate the hematocrit by multiplying the red cell number (in millions/mm³) by the mean cell volume (MCV, in femtoliters). When so assayed, it is subject to the vagaries inherent in obtaining an accurate measurement of the MCV (see Chapter 152).

Both the hemoglobin and the hematocrit are based on whole blood and are therefore dependent on plasma volume. If a patient is severely dehydrated, the hemoglobin and hematocrit will appear higher than if the patient were normovolemic; if the patient is fluid overloaded, they will be lower than their actual level. To assess true red cell mass, independent radionuclide evaluation of the red cells and plasma (by ⁵¹Cr and ¹³¹I respectively) must be performed.

Technique

Hematocrit

If the hematocrit must be determined quickly, as is often the case when a patient hemorrhages, it may be necessary to measure the hematocrit directly without the use of an automated counter. The materials needed are:

Lancets
Alcohol prep pads
Gauze pads
Microhematocrit tubes (heparinized)
Sealant (“Seal-Ease,” “Crit-Seal,” etc)
Microhematocrit centrifuge
Microhematocrit reader
If venipuncture is required: tourniquet, syringe, tube containing anticoagulant (EDTA, citrate)

For hematocrits obtained by fingerstick, wipe the fingertip pad of the fourth finger of the nondominant hand with the alcohol prep pad. Make certain the area is allowed to dry. Prick the fingertip with the lancet. Place the hematocrit tube near the incision site and allow the blood to flow via capillary action into the hematocrit tube until it is two-thirds to three-fourths full or to a predesignated mark on the tube. Avoid “milking” the finger if possible; this causes the expression of tissue fluids and may result in a falsely low hematocrit. Always fill at least three tubes. For hematocrits obtained by venipuncture, draw a sample of blood into the tube containing anticoagulant and mix well. Dip the hematocrit tube into the blood and allow the blood to rise to the desired two-thirds to three-quarters level. Because blood cells naturally sediment, a prior thorough mixing of the blood in the tube is necessary to ensure accurate reading.

After cleaning the outside of the hematocrit tubes of excess blood, invert the tube slowly so that the blood migrates just short of the bottom end of the tube. Seal the bottom of the tube with sealant. Make certain that little or no air is interspersed in the column of blood. If the seal is incomplete, leakage will occur during centrifugation and false readings will be obtained.

Place the tubes in a microhematocrit centrifuge and spin for 3 to 5 minutes at high speed. A shorter spin will not allow for complete sedimentation.

Using either a hematocrit reader or any ruled apparatus, measure the length of the column of the packed red cells and divide it by the length of the whole column of blood (cells and plasma), as in . To obtain the hematocrit, multiply this number by 100%. Average all readings obtained from the different microhematocrit tubes.

Figure 151.1

Microhematocrit tube after sedimentation. The hematocrit is a ratio of the packed cells to total volume.

Example: If the column of packed red cells measures 20 mm and the whole blood column measures 50 mm, the hematocrit is 20/50 = 0.4 or (0.4 × 100%) = 40%.

Hemoglobin

Hemoglobin determinations will usually be performed by an automated cell counter from a tube of well-mixed EDTA-anticoagulated blood filled to a predetermined level. In this assay, all forms of hemoglobins are converted to the colored protein cyanomethemoglobin and measured by a colorimeter. An inadequate sample, whether due to insufficient volume or inadequate anticoagulation, may give false readings. If it is necessary to determine the level of anemia quickly, the hematocrit is an easier, more convenient test.

Hemoglobin Electrophoresis

Hemoglobin electrophoresis measures the mobility of hemoglobin in an electric field; it can therefore detect only those abnormalities in hemoglobin that alter the charge. Electrophoretic mobilities are affected by pH and by the medium in which the test is conducted. Screening tests typically use a hemolysate of anticoagulated blood electrophoresed on cellulose acetate at pH 8.6 to 8.8. If necessary, a further electrophoresis in starch gel at pH 6.2 to 6.8 is performed. At that stage, the work will usually be performed by a specialized laboratory.

Hemoglobin electrophoresis will not readily assess situations where there are neutral amino acid substitutions or where the hemoglobin is normal but the constituent chains are not produced in equal numbers (thalassemias). The diagnosis of alpha thalassemia of a mild to moderate degree cannot be made by hemoglobin electrophoresis; the diagnosis of beta thalassemia may be made by inference from an increase in the Hb A₂.

A standard electrophoresis would look like .

Figure 151.2

A standard hemoglobin electrophoresis (cellulose acetate, pH 8.6).

Basic Science

The molecular weight of hemoglobin is approximately 64,500 daltons. Hb is composed of two pairs of dissimilar chains, α and β, each defined by a specific amino acid sequence and incorporating an iron-containing heme group. Two α–β dimers combine to form a hemoglobin tetramer. This allows for the “heme–heme” interaction necessary for effective oxygen uptake (deoxyhemoglobin → oxyhemoglobin) and delivery (oxyhemoglobin → deoxyhemoglobin). The oxygen affinity of hemoglobin is a function of this heme–heme interaction and of pH (Bohr effect), and is a measure of how many hemoglobin molecules have oxygen bound to them for a given level of oxygen tension. In a normal individual the major hemoglobin is Hb A, constituting approximately 97% of the total hemoglobin. Variations and/or amino acid substitutions in these chains exist. Some are deleterious to the normal function of hemoglobin, whereas others may have relatively normal oxygen affinity and stability. Hemoglobins containing different types of chains make up the remainder of the hemoglobin content in red cells (α₂δ₂ = Hb A₂ approximately 2%; α₂γ₂ = Hb F approximately 1%).

Substitutions in the normal hemoglobin amino acid sequence may result in hemoglobins that have different sub-unit interactions and varying affinities for oxygen. For example, a substitution of the sixth amino acid on the beta chain causes Hb S, or sickle hemoglobin. Hb S has a lower oxygen affinity and surrenders its oxygen more readily. Hb F, a normal minor hemoglobin constituent, has a higher oxygen affinity.

If the oxygen dissociation curve is abnormal, the body will adjust the hemoglobin level to ensure adequate oxygen distribution to the tissues. Thus in a rare disease like hemoglobin Hotel Dieu, the difficulty in extracting oxygen from a variant hemoglobin with increased oxygen affinity could result in a lack of oxygen for the tissues (tissue hypoxia) and a compensatory erythrocytosis. The smaller fraction of oxygen released from the hemoglobin is thereby offset by the increased number of hemoglobin molecules. Similarly, in sickle cell anemia, the decreased oxygen affinity allows these patients more tissue oxygen at any given hemoglobin level.

Clinical Significance

Many anemias are detected by routine laboratory screening performed before the patient is symptomatic. When the patient does have symptoms from an abnormality in the hemoglobin level, the symptoms are often a nonspecific weakness or fatigue. The only finding on physical examination may be pallor; additional changes in the nail beds (such as spooning), glossitis (red tongue), or hepatosplenomegaly (enlarged liver or spleen) may give a clue to the etiology of the anemia. Symptoms are usually related to the level of hemoglobin, its abruptness of onset and its duration. A patient with pernicious anemia may feel well at the same level of hemoglobin that would cause severe weakness in a patient with acute gastrointestinal hemorrhage. This is due to volume compensation by plasma and shifts in the oxygen dissociation curve which occur over time.

When first confronted with an abnormal hemoglobin or hematocrit level, the next step is to assess the red cell indices (see Chapter 152), peripheral smear (Chapter 155), and the reticulocyte count (Chapter 156) in light of the patient’s history and physical examination.

References

Adamson JW, Finch CA. Hemoglobin function, oxygen affinity and erythropoietin. Annu Rev Physiol. 1975;37:351. [PubMed: 235878]
Bunn HF. Hemoglobin I. Structure and function. In: Beck WS, Hematology. Cambridge, MA: MIT Press, 1981;129.

Diagnosis | Leukemia and Lymphoma Society

While a person may have certain signs and symptoms of polycythemia vera (PV), laboratory tests are needed to confirm the diagnosis. Generally, a doctor will consider other conditions first.

Sometimes a condition called “secondary polycythemia” is causing the increase in red blood cells but, unlike PV, it does not begin in the bone marrow and is not a cancer. High red blood cell counts caused by secondary polycythemia are a reaction to another problem such as:

High altitude
Disease that leads to low oxygenation of the blood
Kidney or liver tumor that secretes the hormone erythropoietin
Inherited disease

Secondary polycythemia is managed primarily by treating the underlying condition causing the disorder. A patient with secondary polycythemia should have a return to normal red blood cell counts once the primary problem is successfully treated.

Medical History and Physical Examination

Evaluation of an individual with suspected PV should start with a detailed medical history and a physical examination by a hematologist-oncologist

The medical history should include information about the patient’s:

Cardiovascular risk factors
Past illnesses
Injuries
Treatments
Medications
A history of the formation or presence of a blood clot inside a blood vessel (thrombosis) or loss of blood from damaged blood vessels (hemorrhagic events)
History of blood relatives—some illnesses run in families
Current symptoms

After the medical history, the doctor will conduct a physical examination. During the physical examination, the doctor may:

Listen to the patient’s heart and lungs
Examine the patient’s body for signs of disease
Check different organs of the body

Blood Tests

Complete Blood Count

This test measures the number of red blood cells, white blood cells and platelets in a sample of blood. It also measures the amount of the iron-rich protein that carries oxygen in red blood cells and the percent of whole blood made up of red blood cells (the hematocrit). People with PV have high red blood cell counts. They also often have:

Increased white blood cells and platelets
Increased hemoglobin levels
Increased hematocrit levels

Red Cell Mast Test

This procedure is used to measure the volume (amount) of red blood cells in relation to the volume of plasma (fluid) in whole blood. In patients with PV, there may be an absolute increase in red blood cell mass. This test is infrequently performed in the United States due to high cost, difficulty obtaining the appropriate test materials, and the advent of new blood tests such as mutational testing.

Peripheral Blood Smear

A procedure in which a blood sample is viewed under a microscope. A pathologist examines the sample to see if there are any unusual changes in the size, shape and appearance of various blood cells. The test also checks for the presence of immature (blast) cells in the blood.

Comprehensive Metabolic Panel

These tests measure the levels of substances released into the blood by organs and tissues. These include electrolyes, fats, proteins, glucose (sugar) and enzymes. Blood chemistry tests provide important information about how well a person’s kidneys, liver and other organs are working. For patients suspected of having PV, it is important to test the serum erythropoietin level. Erythropoietin is a hormone naturally produced by the kidneys to stimulate the production of new red blood cells. Individuals with PV usually have very low levels of erythropoietin.

Bone Marrow Tests

Your doctor may examine your bone marrow even though the test isn’t needed to diagnose PV.

Bone marrow testing involves two steps usually performed at the same time in a doctor’s office or a hospital:

A bone marrow aspiration to remove a liquid marrow sample
A bone marrow biopsy to remove a small amount of bone filled with marrow

In PV, the bone marrow shows above-normal numbers of blood cells and an abnormal number of the platelet-forming cells called “megakaryocytes” in the bone marrow. The pathologist also examines the chromosomes of the bone marrow cells to rule out other blood diseases.

Molecular Testing

Molecular genetic tests are very sensitive tests that look for specific gene mutations. If PV is suspected, molecular testing for the JAK2 mutation should be performed. The JAK2 V617F mutation is found in more than 90 percent of PV patients.

The U.S. Food and Drug Administration (FDA) has approved a test called ipsogen JAK2 RGQ PCR Kit to detect mutations affecting the Janus Tyrosine Kinase 2 (JAK2) gene. This test is intended to help doctors evaluate patients for suspected PV.

For more information about bone marrow tests and other lab tests, please see the free LLS publication Understanding Lab and Imaging Tests.

Criteria for Diagnosing Polycythemia Vera

In 2016, the World Health Organization published new criteria for diagnosing PV. The diagnosis of PV requires the presence of

Major Criteria 1, 2, and 3 (listed below) or
Major Criteria 1 and 2 and the minor criterion(listed below)

Major Criteria 1. Very high red blood cell count, usually identified by either A, B, or C below:

A. Hemoglobin level
- Elevated levels of hemoglobin
  - Hemoglobin levels greater than 16. 5 g/dL in men
  - Hemoglobin levels greater than 16.0 g/dL in women
B. Hematocrit level
- Elevated levels of hematocrit
  - Hematocrit greater than 49 percent in men
  - Hematocrit greater than 48 percent in women
C. Red cell mass

Major Criteria 2. Bone marrow biopsy (A or B below) showing:

A. An abnormal excess of blood cells in the bone marrow (called “hyercellularity”) with an elevation of red blood cells, white blood cells and platelets (called “panmyelosis”)
B. Proliferation of mature megakaryocytes that vary in size and shape

Major Criteria 3. Presence of the JAK2V617F or JAK2 exon 12 gene mutation

Minor Criterion: Very low levels of erythropoietin

Deciphering the blood test – Scandinavia Clinic

After donating blood, we are left alone with a long list of indicators, and sometimes with frightening marks “above normal” or “below normal”.Let’s figure out what is hidden behind the abbreviations, and why the numbers can change.

A clinical blood test is prescribed to determine the number of cells, their external parameters and the ratio with the liquid part of the blood – plasma. This is usually needed to check the general condition of the body, to determine inflammation. The counting is carried out by an automatic device, but a doctor can also do this by examining a smear in a microscope.

To get the correct results, you need to properly prepare for the delivery.The main recommendation is to be tested in the morning on an empty stomach. Your doctor may give you additional instructions, such as avoiding fatty foods, drinking alcohol, or exercising a day. These guidelines should be followed.

RBC (Red blood cells) – the absolute number of red blood cells

Red blood cells are red blood cells. They contain the protein hemoglobin, which binds and carries oxygen and carbon dioxide. Thus, red blood cells perform an important transport function, so there are more of them in the blood than other cells.

If there are very few red blood cells or hemoglobin, this condition is called anemia. Its appearance is associated with a deficiency of iron, vitamin B12, folic acid. Anemia often accompanies pregnancy.

An increase in the number of red blood cells is called erythrocytosis or polycythemia. The increase can be relative, for example, with dehydration, diarrhea, or smoking, when the plasma becomes less.

Or it can be absolute, when the production of red blood cells increases dramatically.The reason may be mutations in bone marrow stem cells – the progenitors of red blood cells, or an increase in the level of the hormone erythropoietin. Inhabitants of the highlands, where there is not enough oxygen, face such a condition. Tumors can also interfere with the production of erythropoietin.

HGB – the concentration of hemoglobin in the blood

Hemoglobin is a complex protein found in red blood cells. Normally, it binds to oxygen and carbon dioxide molecules. The amount of hemoglobin differs depending on age and gender.

A lack of hemoglobin indicates anemia, but additional tests are needed to establish its cause. The excess of hemoglobin, as well as of erythrocytes, can be relative, as with dehydration, or absolute, against the background of high-altitude hypoxia, high levels of erythropoietin and other factors.

Erythrocyte indices (MCV, MCH, MCHC)

The blood test describes the parameters of erythrocytes, or erythrocyte indices. They help to establish the cause of anemia, since fluctuations in these indicators indicate a violation of the process of erythrocyte production.

MCV – average erythrocyte volume

By the value of this parameter, anemia can be classified.

Microcytosis – a decrease in the parameter. The case may be iron deficiency or a violation of hemoglobin synthesis – thalassemia.

Macrocytosis – an increase in the parameter. It can be observed with a deficiency of vitamins B12, folic acid, liver disease and bone marrow disorders.

MCH – average hemoglobin content in a single erythrocyte

The decrease in MCH may be due to iron deficiency or impaired hemoglobin production.MCH can increase with a deficiency of vitamin B12, folic acid.

MCHC – the average concentration of hemoglobin in the erythrocyte mass

This is an indicator of the saturation of the erythrocyte with hemoglobin. Low MCHC values are characteristic of iron deficiency anemia, and very high values can reflect spherocytosis or agglutination — the adhesion of red blood cells.

RDW – distribution of erythrocytes by volume

The RDW parameter evaluates the volume heterogeneity of a group of erythrocytes.If this parameter is increased, then the heterogeneity is high – there are too large and too small erythrocytes.

An increase in RDW is characteristic of iron deficiency anemia, myelodysplastic

syndrome – disorders of maturation of bone marrow cells, chronic liver and kidney disease, colorectal cancer.

If there are too many non-standard cells in the sample, the analysis results may show marks: anisocytosis – the presence of cells with a changed size, anisochromia – with a changed color, poikilocytosis – with a changed shape.This is typical for different types of anemia.

B-Ret – reticulocytes

These are young precursor cells of erythrocytes, which are formed in the bone marrow and circulate in small quantities in the blood.

There are more reticulocytes in the blood when the bone marrow receives a signal to increase the production of red blood cells. This can occur with hemolytic anemia, a condition in which red blood cells are destroyed faster than expected.

A decrease in the number of reticulocytes is observed in the case of disruption of the bone marrow with aplastic anemia, as well as with a deficiency of iron, vitamin B12 and folic acid, kidney and liver diseases.

HCT – hematocrit

This indicator reflects the ratio of the volume of red blood cells and the liquid part of the blood, that is, it shows how thick the blood is.

If the indicator is increased, most likely there is a fluid deficiency in the body.This is the most common cause of high hematocrit. Other possible causes are lung disease, congenital heart disease, and polycythemia, a condition that is characterized by an increase in the number of blood cells.

If the hematocrit is low, it may indicate a deficiency of iron, vitamin B12 and folate, kidney or bone marrow disease such as leukemia, lymphoma, multiple myeloma.

PLT – platelets

Platelets are small platelets of blood.If the vessel is damaged, they are sent to the site of the accident and participate in the formation of a blood clot to stop bleeding.

Decreased platelet count – thrombocytopenia. It can be a consequence of a malfunction of the bone marrow, in which blood cells are formed. Causes: aplastic anemia, leukemia, vitamin B12 deficiency. Other reasons are platelet destruction due to autoimmune disease or from exposure to certain medications.

There is also a natural decrease in the number of platelets during menstruation or pregnancy, which in most cases is not a pathology.

Sometimes thrombocytopenia is false due to the fact that platelets stick together in a test tube under the influence of a reagent.

An increase in platelet count is called thrombocytosis or thrombocythemia. This condition may be due to chronic inflammatory processes, such as rheumatoid arthritis or tuberculosis. Thrombocytosis is also seen in acute infections, iron deficiency anemia, and after removal of the spleen. An increase in the number of platelets can be observed with disruption of the bone marrow – myeloproliferative diseases.

MPV – mean platelet volume

A decrease in the MPV index is observed with a violation of the formation of blood cells in

bone marrow, for example, with aplastic anemia, as well as under the influence of certain drugs.

An increase in MPV occurs with increased activity of the bone marrow: younger large platelets enter the bloodstream. This can lead to increased destruction of platelets, myeloproliferative diseases, preeclampsia during pregnancy.

WBC (white blood cells) – the absolute content of leukocytes

Leukocytes are white blood cells. Their main function is to protect the body from any pathogens and tumor cells.

Several groups of cells are called leukocytes: neutrophils, lymphocytes, eosinophils, monocytes and basophils. Each of them has a separate function.

In a blood test, the total number of leukocytes is indicated in absolute value – the number of cells per liter.And each group is indicated either as a percentage of the total number of leukocytes, or also in absolute value.

If the total number of leukocytes fluctuates, it is important to determine through which group the change occurred.

Decrease in the number of leukocytes – leukopenia. It is observed with disruption of the bone marrow, autoimmune diseases, leukemia. A drop in white blood cell counts is characteristic of some infections, such as HIV or hepatitis. May occur against the background of chemotherapy, as well as certain medications (gastroprotective agents, antipsychotic).

An increase in leukocytes – leukocytosis. It can be both physiological and

pathological. Physiological leukocytosis, that is, natural, helps the body fight infection. There are many reasons for pathological leukocytosis. It can be a sign of inflammation, tumor, bone marrow dysfunction, or corticosteroid use.

NEUT – neutrophils

Neutrophils, or neutrophilic granulocytes, are one of the groups of leukocytes.Their main function is to protect the body from bacterial and fungal infections.

Decreased neutrophils – neutropenia. This condition is caused by the use of certain drugs, exposure to radiation, infections, vitamin B12 deficiency, aplastic anemias, immunodeficiencies, and autoimmune diseases.

An increase in the number of neutrophils – neutrophilia. It is observed in inflammatory reactions, infectious processes, tumors and autoimmune diseases, such as rheumatoid arthritis.

LYM – lymphocytes

Lymphocytes are another group of white blood cells that are the main cells of the immune system. They fight pathogens, form long-term immunity, destroy tumor cells, and are also responsible for the tolerance of the immune system to its own cells and tissues.

A decrease in the number of lymphocytes – lymphopenia. Causes of lymphopenia: viral infections – influenza, hepatitis, tuberculosis and HIV, fasting, intense physical activity, taking the hormone prednisone, chemotherapy, autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, myasthenia gravis), some types of cancer (leukemia and lymphoma).

An increase in lymphocytes – lymphocytosis is characteristic of infections: chickenpox, measles, mononucleosis, and can also be a sign of a tumor process.

EOS – eosinophils

Eosinophils are another group of leukocytes. The main function is to fight multicellular parasites. In addition, eosinophils are involved in the formation of allergic reactions.

An increase in the number of eosinophils in the blood – eosinophilia.It is necessary to pay attention to this parameter, because mainly eosinophils are in the tissues, there are very few of them in the blood – 0.5 – 2% of the total number of leukocytes.

Common causes of eosinophilia: allergic diseases such as bronchial asthma, food or drug allergies, hay fever. In the list of reasons – defeat by parasites: ascaris, echinococcus, lamblia and others. Rare cases of eosinophilia are seen in cancer – lymphoma and leukemia.

MON – monocytes

Monocytes are a group of leukocytes.Their main function is to absorb foreign cells and present them to other cells of the immune system. They also activate the production of cytokines, proteins responsible for the body’s inflammatory response. Basically, monocytes circulate in tissues, there are few of them in the blood.

Increased monocytes – monocytosis. This condition is observed with infections: chickenpox, malaria, typhoid fever, tuberculosis, syphilis. Typical for autoimmune diseases, as well as tumor diseases of the blood – leukemia.

Decrease in monocytes – monocytopenia. May result from infections: HIV, Epstein-Barr virus, adenovirus. And it is also observed with chemotherapy, lymphoma, leukemia.

BAS – basophils

Basophils are a type of white blood cell. The main function is to participate in inflammatory and allergic reactions. Changes in the number of these cells in the blood are rare.

The increased content of basophils – basophilia.It can be observed with hypothyroidism – a persistent lack of thyroid hormones, as well as with diseases of the bone marrow.

A decrease in the number of basophils – basopenia. It can appear in response to thyrotoxicosis – an excess of thyroid hormone, as well as in acute hypersensitivity reactions and infections.

Now, having noticed changes in the clinical analysis of blood, you can assume

possible reason. But do not make a diagnosis on your own, all the more so only for one indicator.Be sure to consult a doctor for accurate interpretation, prescribing additional tests and choosing treatment tactics.

90,000 Analysis for Hematocrit – what is it, what does

depend on

Hematocrit – what is it, what does it depend on

Analysis for hematocrit gives data on the ratio of the volume of red blood cells to the total volume of blood, occasionally this indicator means the ratio of the volume of all formed elements to the total volume. There is no particular difference between the interpretations, 99% of the volume of blood cells is in red cells.More often, the hematocrit is recorded as a percentage of the total volume, less often as a ratio of the volume of cells to the total volume of blood.

This indicator is determined as part of a complex blood count It refers to secondary, calculated on the basis of data on the number of red blood cells. Occasionally, a direct measurement of the hematocrit is carried out by centrifuging the sample taken. This procedure allows you to separate the plasma from the corpuscles and directly measure this indicator.

Indications and preparation for analysis

The indications for the analysis of hematocrit are symptoms indicating the development of anemia or other diseases of the blood, hematopoietic system. These include:

Pallor or yellowness of the skin
Enlargement of the spleen, liver
Changes in the size of the lymph nodes
Digestive disorders
Problems with the skin and hair (rashes, ulcers on the mucous membranes, hair loss or brittleness)

In addition to detecting anemia, the analysis allows you to identify other diseases, for example, polycythemia (a chronic disease in which the bone marrow produces an excessive amount of red blood cells) of various origins.Also, this study is used when it is necessary to assess the need for blood transfusion, to calculate the required volume of transfusion.

No special preparation is required for the hematocrit test. It is necessary to follow the standard rules for conducting a general blood test:

Blood is taken early in the morning.
Do not eat 6-10 hours before the test.
Avoid alcohol 2-3 days before the procedure.

Patients who smoke are advised to refrain from smoking for at least 2-3 hours prior to blood sampling.If these recommendations are not followed, the analysis may give unreliable results. This is due to the fact that the composition of the blood is subject to strong fluctuations depending on the action of various environmental factors.

Blood test for hematocrit

Manipulation is performed in the morning, blood is taken from a vein or from a finger. In the Medart clinic, the most modern equipment is used for the analysis, therefore, most often the sampling is performed from a vein.

To obtain the material, special vacuum containers (vacutainers) are used.This is a modern syringe replacement that provides a number of benefits for the patient:

Virtually painless procedure.
Minimum time to obtain the correct amount of blood.
Accurate calculation of the amount of reagent and blood.
The minimum time to conduct the study and issue the results to the patient.

Modern technologies make it possible to carry out the manipulation as quickly as possible, without consequences for health.

Standards

The normal level of hematocrit depends on the age, sex of a person.For a mature woman, it is 37-50%, for a man 34-45%. For newborns, this figure can be higher and ranges from 35 to 65%. In the process of growing up, the hematocrit decreases, reaching minimum levels in the elderly. This is the result of a decrease in the activity of the bone marrow and a decrease in the production of blood cell elements.

A decrease in the normal hematocrit in women is associated with regular blood loss during menstruation. High values in children are a manifestation of active processes of development of the red bone marrow and other hematopoietic organs.

It is important to take into account that after massive blood loss, blood transfusions, determination of the hematocrit level will give a result with a large error. For a reliable assessment of this indicator in such cases, it is necessary to wait a certain time.

It may take up to 3 months for the full physiological recovery of the level of red blood cells to normal values. This period is the life cycle of erythrocytes, during which the cellular composition of the blood is renewed.

Hematocrit increased

An increase in the level of erythrocytes revealed in the analysis for hematocrit may indicate various pathological conditions.Most common:

Primary erythrocytosis. It occurs as a result of overactive production of erythrocytes, including immature forms. May indicate the development of tumors in the bone marrow.
Secondary erythrocytosis. It develops as a consequence of pathologies of the respiratory and cardiovascular systems (heart defects, respiratory failure).
Reduction of plasma volume. May indicate the development of peritonitis, leukemia, kidney disease. Often occurs with extensive burns, when blood plasma flows through the damaged dermis.
Dehydration. It is observed in uncompensated diabetes mellitus, can result from diarrhea, vomiting, excessive sweating and lack of fluid in the diet.

Erythrocytosis can develop in heavy smokers, especially if smoking has led to secondary lesions of the respiratory system and heart. In this case, the body turns on the mechanisms of compensation for insufficient oxygenation due to a significant increase in the number of red cells.

An increase in hematocrit is not always a consequence of disease.An increase in the number of red blood cells is considered normal for mountain residents, professional climbers. With a sufficiently long stay in high altitude conditions, the body compensates for the lack of oxygen and atmospheric pressure by increasing the production of red blood cells.

Erythrocytosis is often asymptomatic, detected by chance, when taking a blood test for other reasons. Only with a significant increase in hematocrit are observed:

Pain in joints, muscles.
Shortness of breath.
High blood pressure.
Tinnitus and dizziness.
Excessive sweating, sleep disturbances.

These symptoms are not specific, therefore, if such ailments appear, you should consult a doctor for further diagnosis.

To restore the physiological level of hematocrit, it is required to find out the reason that led to the increase in the number of blood corpuscles and eliminate it. For example, if erythrocytosis was caused by dehydration (lack of water in the body – dehydration), it is enough to restore the normal amount of fluid to normalize this indicator.

There is no need to self-medicate, only a specialist can determine the exact cause of the hematocrit growth and prescribe the correct diagnosis and treatment. Therefore, for any changes in the blood test, you need to consult with a specialist and strictly follow the recommendations received.

Hematocrit lowered

The main reason for the decrease in hematocrit is anemia. There are many reasons for the development of these diseases, the most common are:

Disorders in the process of erythrocyte maturation.Associated with a lack of iron and B vitamins in food or their insufficient absorption from the digestive system. Less commonly, it occurs with the development of malignant tumors, whose cells compete with healthy ones and intensively absorb vitamins and minerals.
Abundant blood loss as a result of trauma or surgical procedures. Loss of blood does not always have to be instantaneous; the cause may be a slight but regular bleeding from hemorrhoids or heavy periods.
Enhanced destruction of red blood cells. It occurs in case of poisoning with chemicals and organic poisons, after snake bites. Less commonly, it can occur when the liver and spleen malfunction. They are accompanied by severe jaundice, enlarged liver, intoxication, and other symptoms of massive destruction of red blood cells.

Not only anemia can lead to a decrease in hematocrit. Excessive accumulation of water in the body with impaired renal function is often the cause of this condition.Severe infectious diseases can contribute to a decrease in the number of formed elements.

The main manifestations of a reduced hematocrit include:

Pale skin, hair loss and brittle nails.
Appearance of desire to use land, chalk.
General fatigue, drowsiness.
Bluish tint of the sclera.
Increased heart rate.

If one or more of these symptoms appear, you should consult a doctor to determine the cause of the decrease in the hematocrit level.Often, to restore this indicator, it is enough to normalize nutrition, saturating the body with vitamins, proteins, and a number of other active substances that are indispensable for the synthesis of red blood cells.

It is important to consider that a decrease in hematocrit may be a normal variant. Often this indicator decreases in 2-3 trimesters of pregnancy. The reason for the phenomenon is a rapid increase in the proportion of plasma in the blood of a pregnant woman, which the body does not have time to compensate by activating the red bone marrow.In most cases, this condition does not require intervention, the blood composition is restored on its own.

If the reason for the decrease in hematocrit is a disease, you need to be examined by a specialized specialist to clarify the diagnosis and select the appropriate treatment regimen. In the case when the cause was blood loss, the tactics of treatment will depend on the amount of blood lost. With blood loss of up to 0.5 liters, sufficient nutrition and bed rest are sufficient. When bleeding large volumes, blood transfusion may be required to compensate for the lost red blood cells.Often it is combined with oxygen therapy – the supply of a gas mixture with an increased oxygen content to the patient for breathing.

90,000 REMOTE EFFECTS OF AUTOLOGICAL HEMOPOIETIC CELLS

Late Effects After Autologous Hematopoietic Cell Transplantation

Linda J. Burns, MD, Associate Professor of Medicine and Fellowship Director of the Hematology, Oncology, and Transplantation Program at the University of Minnesota, Minneapolis, MN.

Reported by Edward A. Faber, Jr., DO, MS.

Improvements in concomitant therapy decreased the number of patients suffering from early complications of treatment; therefore, more attention is paid to the causes of complications and mortality in the long-term period. The increase over the past three decades in the number of autologous hematopoietic stem cell transplants (auto-HCT) has coincided with a 15% to 2% decline in transplant-related mortality (TRM). Interpretation of the data is very difficult, since the definition of “distant” varies by researchers, and is also associated with the observed cohort of patients, the disease under consideration, the modes of mobilization and transplantation, and the source of stem cells.Methods (relative risk, standardized mortality, actuarial estimate, or cumulative rate) generally took into account that the rate of long-term complications over time differs between studies or is not explained in sufficient detail. It also begs the question: Should comparisons of auto-HCT patients be performed against only other auto-HCT patients, or against a “standard” population?

Numerous studies contribute to the current understanding of long-term complications and causes of death in adult patients.A major study designed to explain the causes of long-term mortality in patients who have lived more than two years after HCT has identified the most common cause of non-relapse mortality (NRM) – secondary tumors, the frequency of which increases after the use of carmustine and peripheral blood stem cell transplantation (PBSC ). Studies indicate that secondary malignancy rates range from 0.7% to 24%. A study of 1193 children and adults established the risk of developing second tumors.The cumulative incidence of prior therapy-related myelodysplastic syndrome and acute myeloid leukemia has a stable plateau for 10 years after HCT (higher trend with PBSC). In contrast, the risk of developing solid tumors continued to increase even 20 years after transplantation. Relapses of the underlying disease, previous lines of chemotherapy and age are risk factors for the development of secondary tumors.

Although the 10-year incidence rate of myelodysplastic syndrome (MDS) after auto-HCT for multiple myeloma was reported to be 1%, patients with low CD34 (<3x10 ⁴ / kg and> 2 apheresis) and patients with post-HCT consolidation chemotherapy had a higher incidence of secondary myeloid hematological malignancies.Chromosomal damage from> 1 prior chemotherapy regimen or mobilization chemotherapy may predispose to the formation of pre-leukemic stem cell clones.

For more than a decade, the question of the influence of HCT timing (pre-HCT, peri-HCT and post-HCT) in the development of secondary malignancy has been raised. Several studies have noted that pre-HCT abnormalities not detected by cytogenetic analysis could be detected by fluorescence in situ hybridization (FISH), suggesting that pre-HCT therapy is the cause of secondary malignancy, especially t-MDS / AML.Two prospective studies demonstrate the association of high cumulative doses of alkylating agents with the development of t-MDS / AML. In contrast, three retrospective studies reported no association with an increased risk of t-MDS / AML. Stem cell treatment with etoposide was associated with a 12.3 increased risk of t-MDS / AML and anticipation of 11q23 / 21q22 abnormalities, but multivariate analysis failed to show any association with HCT.

Infection-related complications have been reported to develop with a median of 28 months.Pulmonary fibrosis has been shown to occur with a median of three years after HCT. Non-final long-term effects include endocrine abnormalities (hypogonadism and hypothyroidism), late infectious complications, cataracts, neurosensory impairment, xerostomia, osteoporosis, while cardiac, pulmonary, and renal pathologies can be fatal. Arterial vascular events, especially cerebral and coronary events, are more common in patients after allogenic transplantation (allo-HCT) than after auto-HCT.Factors associated with cardiac disorders include the number of pre-HCT chemotherapy courses, anthracyclines> 250 mg / m ², comorbid status, and female gender. Chronic renal failure more than a year after HCT has been associated with older age and multiple myeloma.

In addition to the factors described above, pretransplant comorbid status, underlying disease, age, lifestyle and genetics are likely to contribute to the development of chronic infections and delayed organ toxicity.With this in mind, it is logical to take steps to eliminate or reduce the impact of factors associated with delayed effects. Perhaps limiting the use of alkylating agents or avoiding total radiation therapy regimens will help limit the effects of pre-HCT treatments. Any physician involved in post-transplant patient follow-up should be vigilant for the development of t-MDS / AML and secondary solid tumors as well as chronic disease.

Literature:

Baker S, DeFor TE, Burns LJ, et al. New malignancies after blood or marrow stem-cell transplantation in children and adults: Incidence and risk factors. J Clin Oncol. 2003; 21: 1352-1358.
Barlogie B, Tricot G, Haessler J, et al. Cytogenetically defined myelodysplasia after melphalan-based autotransplantation for multiple myeloma linked to poor hematopoietic stem-cell mobilization: The Arkansas experience in more than 3,000 patients treated since 1989.Blood. 2008; 111: 94-100.
Bhatia S, Robison LL, Francisco L, et al. Late mortality in survivors of autologous hematopoietic-cell transplantation: report from the Bone Marrow Transplant Survivor Study. Blood. 2005; 105: 4215-4222.
Burns LJ. Late effects after autologous hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2008; 15 (1 Suppl): 21-24.
Forrest DL, Hogge DE, Nevill TJ, et al. High-dose therapy and autologous hematopoietic stem cell transplantation does not increase the risk of second neoplasms for patients with Hodgkin’s lymphoma: A comparison of conventional therapy alone versus conventional therapy followed by autologous hematopoietic cell stem transplantation.J Clin Oncol. 2005; 23: 7994-8002.
Govindarajan R, Jagannath S, Flick JT, et al. Preceding standard therapy is the likely cause of MDS after autotransplants for multiple myeloma. Br J Haematol. 1996; 95: 349-353.
Harrison CN, Gregory W, Hudson GV, et al. High-dose BEAM chemotherapy with autologous haemopoietic stem cell transplantation for Hodgkin’s disease is unlikely to be associated with a major increased risk of secondary MDS / AML. Br J Cancer. 1999; 8: 476-483.
Jantunen E, Ita “la” M, Siitonen T, et al. Late non-relapse mortality among adult autologous stem cell transplant recipients: A nation-wide analysis of 1,482 patients transplanted in 1990-2003. Eur J Haematol. 2006; 77: 114-119.
Krishnan A, Bhatia S, Slovak ML, et al. Predictors of therapy-related leukemia and myelodysplasia following autologous transplantation for lymphoma: an assessment of risk factors. Blood. 2000; 95: 1588-1593.
Lenz G, Dreyling M, Schiegnitz E, et al.Moderate increase of secondary hematologic malignancies after myeloablative radiochemotherapy and autologous stem-cell transplantation in patients with indolent lymphoma: Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group. J Clin Oncol. 2004; 22: 4926-4933.
Majhail NS, Ness KK, Burns LJ, et al. Late effects in survivors of Hodgkin and non-Hodgkin lymphoma treated with autologous hematopoietic cell transplantation: A report from the bone marrow transplant survivor study.Biol Blood Marrow Transplant. 2007; 13: 1153-1159.
Ruiz-Soto R, Sergent G, Gisselbrecht C, et al. Estimating late adverse events using competing risks after autologous stem-cell transplantation in aggressive non-Hodgkin lymphoma patients. Cancer. 2005; 104: 2735-2742.

What do the indicators of erythrocytes MCV, MCH, MCHC say in the blood test?

What do the indicators of erythrocytes MCV, MCH, MCHC in the blood test say?

Details: Views: 140 490

What do the erythrocyte counts in the blood test say?
What are the indicators of erythrocytes RBC, MCV, MCH, MCHC?

Indicators of erythrocytes (RBC – Red Blood Cells, literally – red blood cells) are separate components of the clinical (general, morphological) blood test, which is also called “complete blood count” or “Complete Blood Count” (CBC ) . Clinical blood test is performed to determine the number of different types of cells found in the patient’s blood and their physical characteristics.

Blood consists of erythrocytes, leukocytes and platelets, which are suspended in plasma. Platelets are cells that provide blood clots and protect the body from blood loss if injured. Red blood cells (RBC) contain the protein hemoglobin, which carries oxygen throughout the body, to all tissues and organs.Red blood cells are pale red in color due to hemoglobin. The shape of the erythrocyte resembles a donut, but instead of a hole in the middle, it has a thinning. In a normal state, all red blood cells in the blood are basically the same color, size, and shape. However, certain conditions can lead to changes that impair their ability to function properly. For example, Anemia .

Anemia is a common blood disorder characterized by too few, deformed or poorly functioning red blood cells.

RBC values determined in the laboratory indicate the size, shape and physical characteristics of RBCs. Your veterinarian can use red blood cell counts to diagnose the causes of anemia.

What are the indicators of erythrocytes MCV, MCH, MCHC for in the blood test ?

Indicators of erythrocytes and their number are used to diagnose various types of anemia. If, as a result of a clinical blood test, it turns out that the patient has too low an indicator of the number of red blood cells or their characteristics differ from the norm, we can talk about some kind of anemia.

Anemia is a condition in which the number of red blood cells or the amount of hemoglobin in the blood falls below normal levels. This impairs gas exchange of tissues throughout the body, causing a lack of oxygen in the organs. With various degrees of anemia, the animal feels unwell, fatigue, dizziness, there is a desire to take a break, and shortness of breath may occur. Symptoms can be accompanied by other abnormalities if the body does not receive enough oxygen to function normally.

What are the causes of anemia in animals?

Anemia can occur if:

too few red blood cells are created, which is called aplastic anemia;

90,081 red blood cells are destroyed prematurely, which is called hemolytic anemia;

significant blood loss occurs, e.g. hemorrhage

Anemia can occur for a variety of reasons:

Anemia can be inherited.This means that the genetic condition is passed from parents to children through their genes;
Anemia can develop suddenly at any time in the patient’s life;
Anemia can be acute, meaning it develops over a short period of time;
Anemia can also be chronic, that is, it develops and persists for, for example, several months

Possible immediate causes of anemia:

diets not containing iron, vitamin B-12, folate or folic acid;

90,081 chronic diseases such as cancer (malignant neoplasms), diabetes, inflammatory bowel disease, kidney disease, or thyroiditis, which is an inflammation of the thyroid gland;

90,081 chronic infections such as feline viral immunodeficiency, tuberculosis, or others;

significant blood loss or hemorrhage;
Diseases affecting the bone marrow such as leukemia (viral leukemia of the feline), lymphoma, or multiple myeloma
chemotherapy;
lead poisoning;
pregnancy;
Certain genetic diseases, such as thalassemia, which is a hereditary form of anemia or sickle cell anemia that occurs when red blood cells cannot carry oxygen well and are sickle-shaped

Iron deficiency anemia is the most common type of anemia.

Symptoms of anemia can be very mild at first. For example, many patients do not even notice that they are anemic. The most common early symptoms of anemia are:

fatigue;

90,081 energy shortages;

weakness;
pale skin

As the disease progresses, new symptoms may appear:

dizziness;
feeling of coldness or numbness in the limbs;

90,081 shortness of breath;

irregular or fast heartbeat;

90,081 chest pain;

headaches

In human medicine, most patients do not know they have anemia until they have a complete clinical blood count (CBC) blood test and find abnormalities.

CBC (Complete Blood Count) is a broad set of parameters that measures the number of all red blood cells, white blood cells and platelets in a blood sample. If the animal is found to be anemic, CBC readings can help determine what is causing the anemia.

What Happens During a CBC?

A small amount of blood must be drawn from the patient to test for RBC indices. Your animal does not need any special preparations for this test, unlike a biochemical test, where a blood sample is taken on an empty stomach after a fasting diet for 6-8 hours.

Next, we describe what happens during CBC:

If blood is drawn from a vein, the veterinarian or assistant will first cleanse the area near the vein from hair, treat it with an antiseptic, and apply a tourniquet above the sampling site so that the vein fills with more blood.

An experienced veterinarian carefully inserts a needle into a vein and slowly draws blood from the bloodstream into a syringe or tube. An intravenous catheter is sometimes used.

When the required amount of blood has been taken, the veterinarian removes the tourniquet, removes the needle and, in some cases, puts a compress over the blood sampling site to prevent hematoma formation.

Then the blood sample is sent to the laboratory for analysis, where laboratory personnel are analyzed using special equipment. It should be borne in mind that a clinical blood test, if it is performed using the old methods using a microscope, gives only an approximate idea of the patient’s condition, since it has a large error. In addition, the calculation of hemoglobin concentration, CBC and parameters such as MCV, MCH, MCHC manually is generally not possible in practice.

In the laboratory of the Kotofey veterinary clinic, a complete CBC blood cell count is performed using an automatic computer-controlled analyzer, which ensures high accuracy and stability of the results.

What are the three main indicators of erythrocyte indices?

Erythrocyte indices have three main indicators:

average body volume (MCV) , which shows the average size of red blood cells;
average corpuscular hemoglobin (MCH) , which shows the average amount of hemoglobin per erythrocyte;
mean corpuscular hemoglobin concentration (MCHC) , which is the amount of hemoglobin relative to the size of the concentration of red blood cells, or hemoglobin per red blood cell

The norms for the indicators of the clinical analysis of blood not only may differ depending on the types of patients (cats, dogs, etc.)but should also be taken into account by laboratory equipment and personnel when performing the analysis. Therefore, the CBC blood test in animals must be performed in specialized veterinary laboratories. It is for this reason that veterinary clinics that use the services of human medicine laboratories in many cases receive incorrect results.

Normal value ranges may vary slightly from laboratory to laboratory.

What do the results of the erythrocyte indices mean?

RBC Index can help your doctor determine the cause of anemia in your animal.MCV is the most useful CBC score and helps determine the type of anemia.

If the veterinarian sees a low, normal, or high MCV, this will help determine the cause of the anemia.

High level MCV

If the MCV is higher than normal, this indicates that there are more red blood cells than usual. This is called macrocytic anemia .

Macrocytic anemia can be caused by the following reasons:

vitamin B12 deficiency;
folate deficiency;
chemotherapy;
pre-leukemic condition

Low MCV

MCV will be below normal if red blood cells are too small.This condition is called microcytic anemia .

Microcytic anemia can be caused by the following reasons:

iron deficiency, which can be caused by poor dietary iron intake, gastrointestinal or other bleeding;
thalassemia;
lead poisoning;
chronic diseases

MCV normal level

Normal MCV means that the patient’s red blood cells are of normal size.A normal MCV can also be accompanied by anemia, for example, if the red blood cells are normal in size but too few, or if other RBC readings are abnormal. This is called normocytic anemia .

Normocytic anemia occurs when red blood cells are of normal size and hemoglobin content, but there are too few of them.

This may be due to the following reasons:

sudden and significant blood loss;
cardiac problems;
tumors;
chronic diseases such as kidney disease or endocrine disorder;
aplastic anemia;
blood infection

High MCHC

If a patient has a high MCHC, it means that the relative concentration of hemoglobin per erythrocyte is high.MCHC may be elevated in diseases such as:

hereditary spherocytosis;
sickle cell anemia;
disease of homozygous hemoglobin C

Low level MCHC

If a patient has a low MCHC level, this means that the relative concentration of hemoglobin per red blood cell is low. Red blood cells appear lighter in color when viewed under a microscope. This is called hypochromia .Patients with anemia and a corresponding low MCHC are called hypochromic .

Causes that can cause a low MCHC include the same causes that cause a low MCV, including:

iron deficiency;

90,081 chronic diseases;

thalassemia;
lead poisoning

Generally, low MCV and MCHC are found together. Anemias in which both MCV and MCHC are low are called microcytic hypochromic anemia .

Conclusion

The veterinarian may also perform other diagnostic tests. Treatment for any anemia depends on the underlying cause. For example, if anemia is caused by an iron deficiency, your doctor may advise you to take iron supplements or change a diet that contains more iron supplements. If the patient has an underlying medical condition that is causing the anemia, treatment for that condition can often also reduce the degree of the anemia.

We recommend that you check with your veterinarian if your animal has any symptoms of anemia or if you have any concerns about the CBC or RBC results.

You can take a CBC blood test with erythrocyte indices RBC, MCV, MCH, MCHC in the city of Dnipro in the independent laboratory of the Kotofey veterinary clinic.

The article was written using materials that are in the public domain.
When writing the article, foreign literature was used.

90,000 Anemia in children | City Children’s Hospital

What is anemia

Anemia is a decrease in the total concentration of red blood cells and hemoglobin in the blood.The task of red blood cells is to deliver oxygen to the tissues of the body. Therefore, with a decrease in their number, the body suffers from the so-called hypoxia – a lack of oxygen. Children are especially sensitive to a decrease in hemoglobin.

According to statistics, anemia is observed in 15% of children. Anemias are very different – some are associated with a lack of B vitamins, others with a deficiency of folic acid. But the vast majority of anemias develop due to iron deficiency. These anemias are called iron deficiency anemias, and they are the most common (about 90% of all anemias).Let’s talk about iron deficiency anemias today.

Causes and symptoms of anemia

The causes of iron deficiency anemia are divided into three groups.

The first is a blood loss situation. This includes bleeding from the gastrointestinal tract, menstrual bleeding, and any other blood loss.

The second group includes the underproduction of iron. And although this is only possible with fasting, it happens in children. For example, when vegetarian parents deliberately deprive the child of meat food – the main source of heme iron.

The next group of reasons is a violation of iron absorption. For some diseases of the stomach or intestines, after abdominal surgery on the gastrointestinal tract. The fact is that iron is absorbed mainly in the duodenum and in the upper parts of the small intestine. Therefore, any problems with these parts of the gastrointestinal tract can provoke anemia.

Anemia can also occur with insufficient production of red blood cells, impaired functioning and premature destruction of red blood cells.

Your child is pale, gets tired quickly, complains of muscle weakness, dizziness.These are the first signs of anemia. Such situations are typical for both schoolchildren and preschool children. Attentive parents sazu will go to see the doctor. If you start anemia, then soon your child will become inactive, cracks will appear in the corners of the mouth, the tongue will become smooth and glossy, “flies” will flicker before your eyes. Perversions in food desires will appear, especially the desire to lick nails and other metal objects.

Your task, as parents, as well as your doctor, is to identify its type, causes and eliminate iron deficiency.

Diagnosis and treatment of anemia

In order to confirm the diagnosis of “anemia”, you need to pass an elementary general blood test (from the finger). According to its results, it will be seen how critical the child’s condition is. If the hemoglobin (HGB) is between 90 and 110, it is mild anemia; 90-70 – moderate anemia; an indicator below 70 is an alarming signal of severe anemia. Pay attention to the number of red blood cells in the blood (RBC). Their norm for children is 4.0-7×1012 (depending on age).

A very important indicator of anemia is the color index of blood. Normally, it should be equal to one. If its value is higher than 1.05, it becomes clear that anemia is caused by a deficiency of B vitamins or folic acid. If CP is less than 0.85, iron deficiency anemia is suspected. There are other criteria on the basis of which the diagnosis of IDA is made, but we will leave their analysis to a knowledgeable doctor.

After the diagnosis is made, the doctor must establish the cause of the anemia, and you must help him with this.Be sure to tell your doctor if your child suddenly does not eat meat or fish, if he has gastrointestinal diseases (ulcerative and pre-ulcerative intestinal conditions). It is very important to find out and eliminate exactly the root cause of anemia, otherwise no treatment will give results, and after a few months anemia will reappear. Treatment for anemia should be comprehensive. It is possible to eliminate only a small iron deficiency with a diet; more serious situations require a complex treatment that combines both a special diet and medications.But more on that later.

Treatment should ONLY be prescribed by a doctor. And it is better if it is a qualified hematologist. An excess of iron is as dangerous for the child’s body as its lack. Therefore, self-medication, you run the risk of seeing symptoms of an overdose – convulsions, vomiting and diarrhea.

Modern iron preparations are produced in easy-to-take forms – in the form of syrups, drops and even chewable tablets. For mild anemia, oral medication is sufficient. Moreover, it is better to drink them with juice, and be sure to take them outside of meals! If the anemia is severe, hospital treatment, parenteral administration of drugs, and sometimes even blood transfusion are indicated.Therefore, do not risk the health of children and, at the slightest suspicion, seek medical help.

Nutrition for anemia. Prevention of anemia

To form the correct principles of nutrition for a child, it is important to understand the mechanism of iron absorption from various sources. The fact is that in red meat, liver and eggs, iron is contained in a rapidly assimilable form – the so-called heme (heme) iron. Plant food (legumes, buckwheat, pomegranates) is a storehouse of non-heme (non-heme) iron, which is less absorbed.Therefore, the child’s menu must necessarily contain meat (beef, rabbit – 30 grams per day), sea fish, eggs (1-2 pieces), berries and juices rich in ascorbic acid. It is ascorbic acid and animal protein that improve the absorption of iron (with simultaneous use by 3 times!). While whole milk and dairy products should be eaten separately from meat, fish and eggs.

Earlier it was believed that a lot of iron is contained in apples. This is not true, since there is exactly as much iron in apples as in buckwheat.Apples simply contain ascorbic acid, which improves the absorption of iron. Therefore, there is no need to force-feed the child with apples, and if he does not like berries and juices, it is better to give the good old vitamin-ascorbic acid. By the way, few people know that dried porcini mushrooms (35 mg per 100 g), seaweed (16 mg per 100 g), cocoa powder (15 mg per 100 g), liver (9 mg per 100 d).

Don’t get sick!

HTC HD mini – middle class

The appearance of the HTC HD2 communicator was a revelation for many: a huge screen, a powerful processor, everything imaginable and inconceivable in a huge body.”From here we will threaten Apple!” – should have been knocked out on the body of the device in gilded letters.

But HTC HD2 has one drawback that is directly related to its advantages: dimensions. For many, especially the representatives of the beautiful half of humanity, it is absolutely impossible to keep such a “brick” by the ear. And the communicator cannot be called light. Another HTC product comes to mind – the Advantage communicator, which no one could surpass in size and weight and, for obvious reasons, did not want to.HTC announced its ability to release incomprehensible devices and then closed the line.

HTC HD2 is a great communicator, but not a mass one. A scaled-down model that fits equally well in a hand of any size, with equally extensive functionality, could become mass-produced. HTC HD mini should be such a communicator.

Delivery set and specifications

HTC HD mini was delivered to edition alone, without accompanying elements and packaging.In the course of communication with the communicator, it turned out that this particular copy of the communicator is not Russified and is clearly not intended for sale in Russia. Be that as it may, the English interface has long been no obstacle to using the communicator: the Cyrillic keyboard layout is added without problems, and with native English inscriptions the communicator interface looks even better than with Russian translations that did not fit into the allotted framework.

The technical parameters of the communicator are as follows:

Processor Qualcomm MSM7227 with a frequency of 600 MHz;
384 MB RAM, 512 MB Flash, 225 MB available;
Operating system Microsoft Windows Mobile 6.5 Professional;
Display 3.2 inches, resolution 320 × 480 pixels, 64 thousand colors, capacitive;
Communication GSM 850/900/1800/1900 MHz, GPRS / EDGE;
Communication 3G UMTS / HSDPA 900/2100 MHz;
Communication Wi-Fi IEEE 802.11b / g, Bluetooth 2.1 + EDR;
GPS-navigation with A-GPS;
FM-radio with RDS support;
microSDHC card slot;
5 megapixel camera with autofocus;
Light sensor;
Position sensor in space;
1200 mAh battery;
Dimensions 103.8 x 57.7 x 11.7 mm;
Weight 110 grams.

The parameters of the review hero meet all the requirements for a modern communicator. There is even an FM radio, which for some reason is found only in mid-range devices, while the top models, for the most part, are deprived of this useful function. All in all, the HTC HD mini has everything an owner might need.

Design and appearance

HTC HD mini is a mid-size monoblock communicator made of black plastic with soft-touch material.Exactly the same can be said about 75% of all mobile computers on sale. However, the hero of the review distinguished himself by even greater rectangularity and austerity of the exterior. Yes, all the edges and corners are rounded, the hardware keys are made of silvery plastic, there are four very “brutal” screws on the back – but still, the appearance of the HD mini does not cause any strong emotions. Of course, every impression is subjective, but the fact that the design of the hero of the review is traditional and somewhat dull is obvious at once. However, for admirers of strict classic dark tones, as well as business suits with diplomats, HD mini will fit.

The dimensions and weight of the communicator make it possible to refer it to the lower weight category, only budget models or just single extravagant products are smaller and lighter. It is obvious that the ergonomics hinders further reducing the communicator – it is not easy to hit the keyboard even with the current screen size. In addition, the current dimensions are ideal from the point of view of controlling the communicator with one finger, which is able to reach all corners of the device’s front panel without having to intercept the device.

The hero of the review is somewhat reminiscent of his larger counterpart in his appearance, but the differences between them are much more than similarities. The NTS HD2 is much heavier, it has hardware keys, and much more metal in the case. HD mini is more “rectangular”, the back panel is flat, completely different battery cover designs and materials are used.

The display and touch keys on the front panel of the communicator are covered with durable plastic resembling glass, so there is no need to worry about scratches.The rejection of separate hardware keys, which is so common in modern mobile computers, causes only bewilderment and sadness. In the dark, touch keys, replacing full-fledged hardware ones, force you to train visual and spatial memory: “Here on the left is the call start key, somewhere in the center of the menu call, on the right the end of the call and two more buttons between them – return to the main and previous screen” … The result is a game: “hit”, “missed”, “hit, but not there.” The backlight, of course, is there, and it saves a little, but how do you find the right key in the wilderness of your bag or in the morning when you sleep? No way.Sacrificed to imaginary aesthetics and design, the absence of hardware buttons constantly reminds us of how unfairly the communicator’s developers did to them. Additional annoyance is caused by random keystrokes.

In the upper part of the front panel there are proximity and ambient light sensors. The first is responsible for disabling the touch screen when talking during a call, the second is used to automatically adjust the backlight level. There is also a LED that informs about the status of the battery and the charging of the communicator, as well as about incoming calls and messages.

In terms of the ratio of the amount of soft-touch plastic to the total area of the communicator, HTC HD mini is a record holder. As a first impression, a false idea comes that the hero of the review is made completely waterproof, so the coating resembles rubber. This plastic covers the entire battery compartment cover, which, in turn, covers not only the back of the case, but also all the side faces of the communicator. Removing the cover using a prepared recess is not the most convenient way. It’s much easier to push down on the speaker and the lid will slide off by itself.The memory card is replaced without removing the battery.

The cover provides holes and recesses for all technological connectors and hardware filling of the communicator. On the back it is: camera lens, speaker, screws. Top: headset jack (3.5 mm) and a panel with a power button for the communicator.

Bottom: microUSB-connector, microphone and lanyard attachment. On the left side there is only a volume control button.

But the most surprising thing is hidden under the black cover – it is bright yellow plastic, from which the main body of the communicator is made.With all the advantages of the black color, if yellow were chosen as the main color, it would have turned out much more original and fun. In its current form, the HTC HD mini is an ordinary “average” communicator with a verified design, but without a zest.

Software and settings

HTC is committed to reworking the software used in communicators. The control system for touch devices HTC Sense significantly distinguishes the models of this brand relative to competitors and in many ways sets the bar for manufacturers of WM / Android-communicators.As one of the largest manufacturers of mobile devices, HTC was one of the first to rework the touch interface of the WM software shell and has been very successful in this. The hero of the review was no exception, where HTC Sense hides the nature of Windows Mobile, which is poorly adapted to finger control.

After switching on the communicator, the system unlock screen appears before the owner. To carry out this operation, it is enough to move the slider. At the bottom of the screen, icons are displayed with information about calls or received messages.

The most significant part of HTC Sense is a collection of bookmarks located on the main screen of the device. The main one contains: clock, weather forecast, call list and calendar. Below are the icons of the remaining tabs: contacts, messages, mail, browser, calendar, stock prices, photo and video album, music, weather, twitter, footprints and settings. To move between them, you can click on the icons or scroll with your finger.

The creators of the communicator have redesigned most of the standard operating system settings windows.Clicking on the upper part of the screen, where the panel with the system status and clock is located, opens a window with quick settings for various parameters of the mobile computer, communication modules and the system. You can access the traditional Windows Mobile settings menu through several levels of HTC Sense options.

Convenient replacements prepared for the following applications: dialer and call list, contact list, message and mail management. If necessary, you can use the usual tools provided by the operating system.

The list of programs for working online includes Opera Mobile – one of the best mobile browsers in its class. However, the standard Internet Explorer Mobile also remained in its place. A separate application is installed to watch videos YouTube . You can post short messages on the Twitter social network using the program Peep .Also in this copy of HTC Sense there is a client of the not very popular network Facebook . Since the communicator entered for testing has a low degree of localization for the Russian and CIS market, in the final communicators these social network clients can be replaced with more suitable analogs.

Since the standard Windows Mobile keyboard is completely unsuitable for finger typing, all communicator manufacturers who care about their potential customers install a replacement for it.Three character input modes are available: QWERTY layout, compact QWERTY with two letters per button, and telephone mode with a small number of buttons. In addition, the XT9 Dictionary can help you quickly and easily enter text. In the keyboard settings, you can connect the functions of automatic completion of words, editing typing errors, a reaction in the form of vibration or sound to pressing a key.

Despite the relatively small diagonal of the display, the good location, the size of the keys on the keyboard and the clear operation of the touch screen allow you to type quickly and with minimal errors.You just need to get used to the layout, press the keys more clearly with your finger and try to avoid cramped places with strong rocking and vibration.

Many programs and utilities are divided in the main menu of the system into several submenus: Tools, Calls, Messaging and Multimedia. The first contains: a connection manager, a program for managing the distribution of Internet traffic via a USB cable or Bluetooth, a voice recorder, a business card scanner, a client for remote computer control – Remote Desktop Mobile , a virtual machine Java , a program for reading PDF documents – Adobe Reader LE and SD card formatting utility.

The program for working with the SIM menu is located in the Calls menu. In Messaging: MSN Messenger and Mail. The Multimedia menu contains shortcuts for the following programs: photo album, Windows Media Player, Audio Booster – equalizer for 3.5 mm headphone output, MP3 Trimmer – utility for simple editing of music files, their “trimming” and setting as a ringtone … In addition, Multimedia contains a client for connecting to Real Time streaming and an FM radio control program.

In terms of the amount of additional software, HTC HD mini is one of the record holders. Together with the communicator, the buyer receives a set of applications for almost all occasions. The undoubted plus and the peculiarity of the software part of the hero of the review, as well as of all other HTC models, is the HTC Sense shell, which attracts the eye and transforms the operating system together with the communicator. If in nature there was a medal for the most chic appearance of the main screen of a WinMobile communicator, it would be worth awarded to HTC devices.

Display and Sound System

The HTC HD mini uses a 3.2-inch TFT matrix with a resolution of 320 × 480 pixels. The operating system supports 64 thousand colors. Subjectively, the HD mini’s screen meets all the requirements for communicators, it is bright and juicy, the selected resolution is enough to demonstrate a high-quality picture, color distortions are not observed even at the sharpest viewing angles. A non-standard resolution can theoretically cause problems in the operation of old programs, but we have not seen such a problem.The brightness of the backlight is automatically adjusted based on the data from the ambient light sensor. If you control it manually, then ten power levels are available, you cannot completely turn off the backlight. Unfortunately, even the maximum power level does not help in bright light – the image fades a lot.

The glass-like plastic cover of the screen is highly reflective and retains all fingerprints. The coating reliably protects the screen and resists attempts to scratch yourself. The capacitive touchscreen did not cause any complaints in terms of the quality of work, all clicks are clear and fast.You just need to be careful with the buttons at the bottom of the front panel, you can accidentally activate them with your finger. The proximity sensor works flawlessly.

The sound subsystem is represented by two speakers, a microphone and a headphone / headset output (3.5 mm). If the main speaker has a good volume level, the power of the telephone speaker sometimes becomes insufficient. The volume is regulated both by software and using the hardware key on the left side of the communicator.

Using the equalizer program, you can change the characteristics of the signal going to the headphones. In general, this need not be done: to an unassuming ear, the quality of the signal arriving at the output satisfies all needs by default. The communicator did not come with a headset, so the subjective test of listening to music and radio was carried out with ordinary in-ear headphones. Again, the unassuming ear did not reveal any sound problems.

The built-in FM radio is controlled by a special program and is operable only when the headphones are connected.Features of the program: display of the signal strength of the radio station and a confusing interface. To find and memorize the desired radio station, you have to change the frequency for a long time by pressing the corresponding buttons, there is no quick frequency entry from the keyboard. There are 20 radio stations in total, but only six are displayed on the main screen. The program recognizes RDS signals and is able to automatically search for radio stations.

The quality of the headphone output is best evidenced by the test result in the RightMarkAnalyser 6 program.0.5. HTC HD mini got good marks.

0 Good

General performance 9000 2

Frequency response (from 40 Hz to 15 kHz), dB	+0.13, −0.71	Good
Noise level, dB (A)	-81 , 6	Good
Dynamic range, dB (A)	82.9	Good
THD,%
THD + Noise, dB (A)	−66.5	Average
IMD + Noise,%	0.144	Average Stereo
	−80.9	Very good
IMD at 10 kHz,%	0.066	Good
41		Good

Detailed report

Wireless interfaces

HTC HD mini is able to exchange information using all modern communication modules, only WiMAX is missing.The communicator automatically adjusts the EDGE / HSDPA data transmission parameters, no problems with access to the worldwide network, as well as with voice communication, were noticed.

A user-friendly connection manager is used to manage all the numerous communication modules. The operating system manages the Wi-Fi connection. The communicator can work as a Wi-Fi access point, distributing Internet traffic to connected devices. Also, traffic can be distributed via Bluetooth and USB connections.

There are no direct indications of the manufacturer of the software for the Bluetooth module version 2.1 with EDR, but the program interface is much more convenient and understandable than the standard analog from Windows Mobile. Numerous work profiles are supported: standard serial port emulation, connection of a keyboard and other HID devices, a modem, access to the address book and SIM card, connection of a headset and stereo headset, transfer of files and objects, connection to a printer and creation of a personal network.

The satellite navigation system in HTC HD mini is represented by Qualcomm gpsOne chip supporting A-GPS technology. This receiver is used in many communicators as it is part of the Qualcomm hardware platform. There are no problems with receiving signals from satellites, positioning on them and on base stations of cellular communication.

As a universal, but very demanding on Internet traffic tool for navigation, you can use the Google Maps program installed in the communicator initially.

Camera

The 5-megapixel camera lens is located on the back panel of the communicator, next to the speaker. It is deeply recessed into the case, which is good from the point of view of its protection, but makes it difficult to clean from dust and dirt accumulating in the hole. There is no flash system.

There is also no hardware key to control the camera. Accordingly, the launch of the program for photographing and video recording is carried out only from the system menu, and the start or end of recording is controlled by pressing a button in the program window.

When photographing, the program window contains only three elements: the frame of the focusing system, the “shutter release” button and the camera settings button. The system constantly adjusts the focus of the camera to the subject in the frame, since usually autofocus is carried out by holding down the hardware button, which HTC HD mini does not have. The focus area can be set by pressing your finger.

The settings key causes additional icons to appear on the screen, as well as a digital zoom bar.Three icons are responsible for opening the photo album, changing the shooting mode and opening additional settings. Among them: white balance, brightness, ISO, changing storage for files, timer and opening a window with all the settings. In total, to get to all the parameters of the camera, you need to successively make three clicks.

In addition to taking photos and recording videos, HTC HD mini can take panoramic shots, record video for MMS, or get a snapshot with GPS coordinates. A panoramic shot is composed of three regular ones.

Video recording is carried out with a resolution of 640 × 480 pixels in MPEG4 / H.263 / H.264 format. There are no restrictions on the length of the video. The quality of the photo can be seen in examples.

Performance and battery life

The processor frequency and the amount of RAM in the HTC HD mini, combined with the lower resolution of the display, determine the fast operation of the operating system and programs. The results of performance measurements in synthetic tests are shown below.To obtain them, a somewhat outdated Spb Benchmark program was used, but it still allows one to compare the capacities of the hardware filling of communicators.

1 MB file (MB / sec)

1 22840 29.3

1031

738 730

90 839

Activeync upload 1 MB file (KB / sec)

	HTC HD mini 600 MHz	Sony Ericia Xsson Xper	Gigabyte GSmart S1200 528 MHz	Garmin-Asus Nuvifone M20 528 MHz	Samsung SGH-i900 WiTu 624 MHz	HP iPAQ 214	index	index	…48	410.74	496.94	401.62	827.48	476.77	461.71
CPU index	2643.85	2041.3	3040.59	2136.83	2044.14	1876.71	2456.25
File system index	420.26	168.34	192.58	162.61	382.57	194.96	187.32
Graphics index	3645.2	1587.81	6129.09	1701.84	4414.46	5832.64	16840		index		index			–	–	–	–
ActiveSync index	17007.5	18578.14	13114.2	15336.56	17138.67	19477.12	2610.86
Write 1 MB file (KB / sec)	2577	1797	1306	1790	1810		24.3	12	6.01	21.3	13.3	16	5.14
1 MB file (KB / sec)	220840 Copy2 176041	220840	1528	1514	1682	3282	1545
Write 10 KB x 100 files (KB / sec)	274	163		285	357	278
Read 10 KB x 100 files (MB / sec)	2.07	2.02	2.41	2.44	2.69	2.03	2.33
Copy 10 KB x 100 files (KB / sec)	300		160	213	512	218
Directory list of 2000 files (thousands of files / sec)	5.69	1.51	1.84	1.37	5.07	1.58	1.79
Internal database read (records / sec)	1981	1061	2119	1172	1074	1467	188 BitBlt (frames / sec)	1070	2500	255	1961	3571	493	152
Graphics test: DIB BitBlt (frames
Graphics test: DIB BitBlt (frames 9040	72.3	23.6	34.9	63.3	15.4
Graphics test: GAPI BitBlt (frames / sec)	342	162			242
Pocket Word document open (KB / sec)	–	–	–	–	–	–	–
Pocket Internet Explorer sec HTML KB load ( )	–	–	–	–	–	–	6.25
Pocket Internet Explorer JPEG load (KB / sec)	–	–	–	–	–	–	110
File Explorer large folder list (files / sec)	1088	514	607	460	885	505	532
Compress 1 MB file using ZIP (KB / sec)	339	333	353	297
Decompress 1024×768 JPEG file (KB / sec)	660	520	1222		613
Arkaball frames per second (frames / sec)	235	114	383	121	205	290	161
CPU test: Whetstones MFLOPS (Mop / sec)	0.112	0.1	0.159	0.108	0.102	0.12	0.12
CPU test: Whetstones MOPS (Mop / sec)	50 54	940	59.5	87.2	84.2
CPU test: Whetstones MWIPS (Mop / sec)	7.73	6.74	10.3		7.03	589	7.72
Memory test: copy 1 MB using memcpy (MB / sec)	134	114	158	114	116	154	126	1483	1689	1168	1397	1599	2695	553
ActiveSync: download 9013 file (KB / sec) 940 3948	3449	2697	2826	2849	1395	133

The fast memory put the HTC HD mini at the top of some of the competition.It is also necessary to take into account the small screen resolution, which leads to a high score in graphic tests. In terms of the performance of the processor itself, the HTC HD mini received a well-deserved high mark, corresponding to 600 megahertz of the main core of the Qualcomm chip. When playing a test video (512 × 384 pixels, bitrate of the stream 2096 Kbps), the test in the CorePlayer program showed a result of 150%. With this indicator, HTC HD mini can comfortably play good quality videos without re-encoding.

The battery life of the communicator when reading text in HaaliReader with 75% backlight was 12 hours 30 minutes. Playing music in GSPlayer with the screen off lasted for 14 hours and 40 minutes. The minimum operating time of the communicator in stand-alone mode is 4 hours 30 minutes at the maximum brightness level of the backlight, activated wireless communication modules and a video clip that is being played back.

In conclusion, it is worth noting that performance and battery life are well balanced in the HD mini.The hero of the review neither there nor there is not enough stars from the sky, but it is quite consistent in both parameters with the expectations of users and the performance of classmate devices.

Conclusions

Let’s list the positive and negative features of HTC HD mini. The former include: small size, good design, excellent hardware, easy-to-use HTC Sense interface. To the second: touch keys that replace hardware. As you can see, positive aspects dominate over negative ones.Let everyone try it for themselves to evaluate the design.

It becomes simply boring to write about mass communicators Windows Mobile in their present form. Indeed, nothing new appears either in the hardware or in the software. The unified HTC lineup with a unified user interface HTC Sense includes models for every wallet and every taste. And if the older models still present surprises and cause surprise, then in the middle price range there is a simple replacement of some good devices with others – with a minimum of differences.