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complete blood count (CBC)

Includes: - White blood cell count (WBC) - Hemoglobin (Hgb) - Hematocrit (Hct) - Red blood cell count (RBC) - Red cell indices - Mean corpuscular volume (MCV) - Mean corpuscular hemoglobin (MCH) - Mean corpuscular hemoglobin concentration (MCHC) - Red cell distribution width (RDW) - Platelet Count (PLTS) - White blood cell differential - Segmented neutrophils (SEGS) - Bands - Lymphocytes (LYMPHS) - Monocytes (MONOS) - Eosinophils (EOS) - Basophils (BASO) Indications: - evaluation of hematologic disease - erythrocyte disorder - leukocyte disorder - platelet disorder - bone marrow disease - coagulation disorder - evaluation of fever/infection - evaluation of autoimmune disease - evaluation of immunodeficiency - evaluation of inflammatory disease - evaluation of hemorrhage - screening for anemia - family history of hematologic disease Reference interval: Component Reference Interval WBC 4.4-11.0 x 10E3/uL Hgb (adult male) 14.0-17.5 g/dL Hgb (adult female) 12.3-15.3 g/dL Hct (adult male) 41.5-50.4% Hct (adult female) 35.9-44.6% RBC (adult male) 4.5-5.9 x 10E6/uL RBC (adult female) 4.1-5.1 x 10E6/uL MCV 80-96 um3 MCH 27.5-33.2 pg MCHC 33.4-35.5% RDW 11.5-14.5% PLTS 150-450 X 10E3/uL SEGS 56% (1800-7800/uL) BANDS 3% (0-700/uL) LYMPHS 34% (1000-4800/uL) MONOS 4% (0-800/uL) EOS 2.7% (0-700/uL) BASO 0.3% (0-200/uL) See specific component for pediatric reference intervals. Specimen: - Whole blood (EDTA). Stable for 24 h at 4 C. Principle: Coulter counter Aspirated (anticoagulated) blood is divided into 2 separate volumes. One volume is mixed with diluent & delivered to the cell bath where erythrocyte & platelet counts are performed. The other volume is mixed with diluent & a cytochemical- lytic agent that lyses erythrocytes for leukocyte determination. The diluted blood specimens are passed through a narrow aperature where the electrical impedance is recorded. The size of the impedance change when a cell passes through the aperature is proportional to the cell size; the number of pulses is related to the cell count. Particles measuring between 2 & 20 fL are counted as platelets & particles measuring > 36 fL are counted as erythrocytes in the first volume. In the second volume, the erythrocytes have been lysed. Particles > 35 fL are counted as leukocytes. Simulataneous measurement of high-frequency electromagnetic energy for nuclear constituents & laser scattering for cell shape & granularity are featured on newer Coulter models. Interferences: 1) erythrocyte agglutination artifactually raises MCV, MCHC & RDW & lowers RBC count 2) platelet aggregation may produce falsely low counts a) enhanced by chelating anticoagulants such as EDTA b) inadequate anticoagulation of blood 3) erythrocyte fragments (hemolysis) or leukocyte fragments (leukemia) may provide falsely elevated platelet count 4) nucleated RBC, malignant cells, platelet clumps or cryoglobulins may be counted as leukocytes

General

clinical hematology test

References

  1. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. Tefferi A, Hanson CA, Inwards DJ. How to interpret and pursue an abnormal complete blood cell count in adults. Mayo Clin Proc. 2005 Jul;80(7):923-36. PMID: 16007898

Component-of

anemia panel deprecated CBC with reticulocyte count DIC panel enteral/parenteral nutrition management panel general health panel hemolysis panel HIV panel obstetric panel obstetric panel HIV renal function tests; renal function panel

Components

basophils in blood eosinophils in blood hematocrit (Hct) of blood hemoglobin (Hgb) in blood lymphocyte count mean corpuscular hemoglobin (MCH) mean corpuscular hemoglobin concentration (MCHC) mean corpuscular volume (MCV) monocyte count neutrophil count platelet count red blood cell count (RBC) red cell distribution width (RDW) white blood cell count (WBC with WBC differential)