The CBC interpretation are useful in
the diagnosis of various types of
It can reflect acute or chronic
infection, allergies, and problems
• Component of the CBC:
• Red Blood Cells (RBCs)
• Hematocrit (Hct)
• Hemoglobin (Hgb)
• Mean Corpuscular Volume (MCV)
• Mean Corpuscular Hemoglobin
- Red cell distribution width (RDW)
• White Blood Cells (WBCs)
• RBC (varies with altitude):
– M: 4.7 to 6.1 x10^12 /L
– F: 4.2 to 5.4 x10^12 /L
• Biconcave disc shape with diameter
of about 8 µm
• Function: - transport hemoglobin
which carries oxygen from the lung to
-acid –base buffer.
• Life span 100-120 days.
M: 13.8 to 17.2 gm/dL
F: 12.1 to 15.1 gm/dL
Hematocrit : (packed cell volume)
It is ratio of the volume of red cell to
the volume of whole blood.
M: 40.7 to 50.3 %
F: 36.1 to 44.3 %
– MCV = mean corpuscular volume
HCT/RBC count= 80-100fL
• small = microcytic
• normal = normocytic
• large = macrocytic
– MCHC= mean corpuscular hemoglobin
concentration HB/RBC count= 26-34%
• decreased = hypochromic
• normal = normochromic
• MCH (mean corpuscular
HB/HCT = 27-32 pg
• RDW (red cell distribution width)
• It is correlates with the degree of
_ Normal range from 10-15%
• This important value is needed in the evaluation
of any anemia.
• Normal range 1-2%
• Retic count goes up with
– Hemolytic anemia
• Retic goes down with
– Nutritional deficiencies
_ Diseases of the bone marrow itself
- Increased number called polycythemia , two types:
- Polycythemia vera
e.g. high attitude, smoking, heart
disease or pulmonary fibrosis
- Decreased numbers of RBCs called anemia may indicate:
1) Blood loss
– Acute (normocytic normochromic)
– Chronic (microcytic hypochromic)
2) Decreased production
e.g._ nutritional anemia
3) Increased destruction
e.g._ hemolytic anemia
• Hemorrhage or thrombosis
• Fatigue ability.
• skin & nail changes
• WBCs are involved in the immune response.
• The normal range: 4 – 11x10^9 /L
• Two types of WBC:
1) Granulocytes consist of:
– Neutrophils: 50 - 70%
– Eosinophils: 1 - 5%
– Basophils: up to 1%
2) Agranulocytes consist of:
- Lymphocytes: 20 - 40%
– Monocytes: 1 - 6%
The type of cell affected depends upon its primary
In bacterial infections, neutrophils are most
In viral infections, lymphocytes are most
In parasitic infections, eosinophils are most
• polymorphneuclear leukocytes
• Nucleus 3-5 lobes.
• Diameter 10-14 µm
• 50-70% WBC
• Function: Phagocytosis of bacteria
and cell debris
• Numbers rise with all manner of
stress, especially bacterial infections
• Neutrophil disorders
– Neutrophilia – an increase in neutrophils
– Conditions associated with neutrophilia are:
1-Bacterial infections (most common cause)
e.g. tissue infarctions, burns.
3- leukemoid reaction
– Neutropenia – this may result from
1-Decreased bone marrow production
e.g. BM hypoplasia.
2-Ineffective bone marrow production
– E.g. megaloblastic anemias and
3- post acute infection
_ e.g. typhoid fever, brucellosis.
• Bilobed nucleus
• 1-5% of WBC
• Diameter about 10-14 µm
• Function: Involved in allergy, parasitic
• Contains: eosinophilic granules
– Eosinophilia may be found in
• Parasitic infections
• Allergic conditions and
• Circulating form of mast
• <1% WBC
• Diameter 10-14 µm
• Contains: basophilic
• Granules contain:
histamine and heparin
• IgE receptors
• Involved in allergy
• Is associated with chronic
• Inflammatory bowel disease e.g.
• Radiation exposure
• 3-8% WBC = 0.2-0.8x10^9/L
• 8-10 µm in diameter.
• Circulating form of tissue
• Life span: 10-20 h in blood,
months in tissues as macrophage.
• Phagocytosis, bacterial killing,
• Peritoneal cavity: peritoneal
• Lung: alveolar macrophages
• Spleen: splenic macrophages
• Liver: Kupffer cells
• Monocytosis associated with
1) certain bacterial Infection
e.g active TB , sebticemia.
2) Protozoal and rickettsial infection
3) Collagen vascular diseases
e.g. Lupus erythromatosis ,rheumatoid arthritis.
• No specific granules
• 20-40% of WBC
• Diameter 8-10 µm
• T cells: cellular
• (for viral infections)
• B cells: humoral
• Natural Killer Cells
• Lymphocytosis – may indicate
_ Viral infection
e.g. Infectious mononucleosis, CMV or pertussis.
_ Bacterial infection
• Lymphopenia – caused by
• (Leukocytosis) may indicate:
_ Infectious diseases
_Inflammatory disease (such as rheumatoid
arthritis or allergy)
_Severe emotional or physical stress
_Tissue damage (e.g. necrosis,or burns)
• (Leukopenia) may result from:
_ Decreased WBC production from BM.
_ Exposure to chemical or drugs.
• Others depend on each system which is involved
e.g. » chest: cough, SOB and chest pain
» abdomen: diarrhea, vomiting,
»CNS: headache, visual disturbance,
and so 0n.
• Infection of the mouth and throat.
• Painful skin ulceration.
• Recurrent infection.
•Small granular non-nucleated
•Diameter about 2-4 µm
•Normal range; 150-300x10^9 /L
•Destroyed by macrophage cells in
•Function; involved in coagulation
and blood haemostasis.
•Life span 7-10 days
• Numbers of platelets
– Increased (Thrombocythemia)
• High attitudes.
– Decreased (Thrombocytopenia)
• Bone marrow destruction or suppression e.g. leukemia
• The values have to fit the clinical situation.
• Petechial hemorhage.
• Easy bruising.
• Mucosal bleeding
e.g. _ epistaxes.
_ gum bleeding
• Sickle cell anemia. Hemoglobin S
• 2 Types of Tests- Screening test for HBs
• Confirmation done by Hemoglobin
• HB AS is Trait- Mild type of disease
• HB SS is disease severe condition.
• Sodium Meta Bisulphite- reducing agent.
• Mixed with RBcs- to produce Sickle RBCS
• HB S in not soluble in Metabisulphite so it
appears as insoluble precipitate or
• All screening test must be confirmed by