4.Haemogram Interpretation.pdf

How to manage it

1. Haemogram
Interpretation
By
Dr M.KATASO
Haematology Unit,
Department of Internal Medicine17/01/2023

2. CBC/FBC Components
•Red Blood Cells (RBCs)
• Hematocrit (Hct)
• Hemoglobin (Hgb)
• Mean Corpuscular Volume (MCV)
• Mean Corpuscular Hemoglobin(MCH)
• Mean Corpuscular Hemoglobin Concentration (MCHC)
• Red cell distribution width (RDW)
• White Blood Cells (WBCs)
• Platelets
• Mean Platelet Volume (MPV)

3. RED BLOOD CELLS(RBCs
Normal range
Males: 4.20 to 5.80 m/uL
Females : 3.80 to 5.20 m/uL
HEMOGLOBIN
Normal range
Hemoglobin :
M: 13.0 to 17.5 gm/ dL
F: 11.5 to 15.5 gm/ dL
HEMATOCRIT
%of the volume of whole blood that is made
up of red blood cells. (Hint: Hb x 3)
Normal range
M: 38 to 54 %
F: 34 to 46.5 %
MEAN CORPUSCULAR VOLUME(MCV )
Formula HCT/RBC
Normal range
80-100fL
• small = microcytic
• normal = normocytic
• large = macrocytic

4. MEAN CORPUSCULAR
HAEMOGLOBIN(MCH )
•Measures the amount, or the mass, of
hemoglobin present in one RBC.
Formula=Hb/RBC count
Normal range
27-34 pg
• Decreased = hypochromic
• Normal = normochromic
• Increased = hyperchromic
MEAN CORPUSCULAR HAEMOGLOBIN
CONCENTRATION(MCHC)
•Measures the proportion of each cell taken up by
hemoglobin
Formula=Hb/HCT
Normal range
32-36 gm/dl
RED CELL DISTRIBUTION WIDTH(RDW)
•Correlates with the degree of anisocytosis or
variation in red blood cell width.
Normal range
10-15%
•Low value indicates uniformity in size of RBCs
•High value indicates mixed population of small
and large RBCs

5. Haemoglobin
Elevated
Primary erythrocytosis
•Polycythemia Vera
Secondary erythrocytosis
•Chronic hypoxia(COPD,
heart disease, high altitude)
-Elevated erythropoietin
due to malignancy
Low
Anemia
•Microcytic
•Normocytic
•Macrocytic
Reticulocyte Production Index(RPI)
•Hyperproliferative(↑2.5)
•Hypoproliferative(↓2.5)
•Hypochromic
•Normochromic
•Hyperchromic

7. White Blood Cells (WBC)
Normal range:
3.5 –10.5x10⁹ /L
Two types of WBC:
1) Granulocytes:
–Neutrophils: 50 -70%
–Eosinophils: 1 -5%
–Basophils: up to 1%
2) Agranulocytes:
-Lymphocytes: 20 -40%
–Monocytes: 1 -6%

8. The Neutrophil
Neutrophilia –an increase in neutrophils
• Bacterial infections
• Tissue destruction (burns)
• Inflammation (SLE, RA, UC)
• Thyrotoxicosis
• Cigarette smoking
• Corticosteroids
• B-agonist
• Leukemia
•Myeloproliferative disorders
•Allergies
•Post splenectomy
Neutropenia –a decrease in neutrophils
• Decreased bone marrow production
•Medications:
cephalosporins,Cotrimoxazole,Chlorpromazine,
dapsone,sirolimus, mycophenolate mofetil,
tacrolimus, cyclosporine,carbimazole,Propyl
thiouracil,Ticlopidine,phenytoin,
Chemotherapy.
• Immune related (ex. SLE, RA)
• Post acute infection (HSV, CMV, HIV, EBV)
•Zinc & Copper deficiency
•Vitamin B12, folate deficiency
•Autoimmune neutropenia

9. The Eosinophil
Eosinophilia:↑eosinophil count
• Parasitic infections
• Allergic conditions and hypersensitivity
reaction
• Aspergillosis
• Vasculitis
•Some cancers, leukemias or lymphomas
•Drug reactions
•Inflammatory disorders (celiac disease,
inflammatory bowel disease)
Eosinopenia:↓Eosinophil count
• Sepsis

10. The Basophils
Basophilia-↑Basophils
•Rare allergic reactions (hives, food
allergy)
•Inflammation (rheumatoid arthritis,
ulcerative colitis)
•Chronic myelocytic leukemia.
•Polycythemia
Basopenia :↓Basophils
•numbers are normally low in the blood
•usually not medically significant
•Corticosteroid therapy,
•Drug induced reactions
•Acute pyogenic infections
•Hyperthyroidism.
•Pregnancy

11. The Lymphocyte
Lymphocytosis –↑lymphocyte count
•Viral infection( EBV, CMV, HIV, Infectious
Mononucleosis)
•Bacterial infections: Pertussis, Tuberculosis
•Parasitic infections: Toxoplasmosis
•Leukemia/Lymphoma (CLL)
Lymphopenia –↓lymphocyte count
•Viral infections
•Medication induced
•Autoimmune disorder
•Bone marrow failure
•Corticosteroids

12. Monocytes
Monocytosis-↑Monocytes
•Pregnancy
•Infections:TB,Syphilis,infective
endocarditis,fungal infections, Protozoan
infections
•Sarcoid
•Collagen vascular diseases :lupus,
scleroderma, rheumatoid arthritis, vasculitis
•Leukemias:Monocytic or myelomonocytic
leukemia (acute or chronic)
Monocytopenia-↓Monocytes
•Acute infection
•Steroids
•Leukemia
•Bone marrow failure

13. Platelets
Normal range
•150-400 x 10⁹/L
Thrombocytosis-↑Platelets
• Splenectomy
• Inflammation(Reactive)
• Myeloproliferative disease (ET)
• Iron deficiency anemia
Thrombocytopenia-↓Platelets
TTP,HUS, DIC, ITP, HIT,VITT,HELLP
syndrome
• Blood loss
• Splenomegaly/ Hypersplenism
• Medications ( antibiotics)
• Viral Infections
• Alcohol abuse
• Bone marrow failure

14. References
•Oxford Handbook of Clinical Haematology, 2nd Edition
•Oxford Handbook of Clinical Medicine, 9th Edition

15. END!!!
Questions??