Full Blood Count

Full Blood Count

13/12/10

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Examinations Book

Data Interpretation – Venkatesh

RED BLOOD CELLS

ANAEMIA

Decreased production – nutritional deficiencies/malasorption, marrow failure, low level of hormones (EPO, thyroid hormones)

Increased production – haemolytic anaemia (congenital/acquired)

Bleeding

Haemodilution

MCV

Anaemia with low MCV - microcytosis

- Fe deficiency

- thalassaemia

- sideroblastic anaemia

Anaemia with high MCV - macrocytosis

- folate or B12 deficiency

- alcohol abuse

- chronic liver disease

- hypothyroidism

- reticulocytosis

- myelodysplasia

Anaemia with normal MCV

- chronic disease

- chronic renal failure

- pregnancy

- haemolysis

- bone marrow failure

- mixed haematinic deficiency (Fe, B12)

Macrocytosis

- alcohol

- B12 deficiency

- folate deficiency

- myelodysplastic syndrome

- therapy with cytotoxics or immunosuppressants

- hypothyroidism

POLYCYTHAEMIA (Hb > 160g/L)

Relative (reduced plasma volume)

- burns

- severe dehydration

Absolute

- polycythaemia ruba vera

- myeloproliferative disorders

- chronic hypoxia (OSA, Eisenmenger’s)

RETICULOCYTOSIS

- acute blood loss

- any cause of premature RBC destruction

WHITE BLOOD CELLS

NEUTROPHILIA

- stress

- sepsis

- leukemoid reactions

- corticosteroids

- malignancy

- vasculitis

NEUTROPAENIA

- infection

- cytotoxic agents

- idiosyncratic drug reactions (clozapine, carbimazole, sulphonamides, beta-lactams)

LYMPHOPENIA

- simple stress response

- prior corticosteroid therapy

- autoimmune disease (SLE)

- infection: viral, severe sepsis, Tb, brucelliosis, histoplasmosis, HIV, CVM

- cytotoxic drugs

- radiation

LYMPHOCYTOSIS

- infection: viral, Tb, toxoplasmosis, syphilis

- thyrotoxicosis

- leukaemia

- lymphoma

ATYPICAL LYMPHOCYTES

- viral infections: EBV, CMV, HIV

- toxoplasmosis

- leukaemia

- lymphoma

- lead poisoning

- drug hypersensitivity

MONOCYTOSIS

- Tb

- leukaemia

- lymphoma

- myelodysplasia

- IBD

- convalescence from any infection

EOSINOPHILIA

- allergy

- Addisons

- parasitic infections

- sarcoidosis

- polyarteritis nodosa

- leukaemia

- lymphoma

- melanoma

- irradiation

- convalescence from any infection

BASOPHILIA

- infection: viral, Tb

- hypothyroidism

- IBD

- polysplenectomy

- leukaemia

- systemic mastocytosis

- haemolysis

- polycythaemia ruba vera

PANCYTOPAENIA

Reduced Marrow Production

- replacement of marrow (malignant cells)

- idiosyncratic Drug Reaction (chloramphenicol, sulphonamides, phenytoin, carbamazepine, gold)

- megaloblastic haematopoiesis (B12 deficiency)

- autoantibodies (SLE)

- myelofibrosis

- myelodysplasia

- toxins (benzene)

- cytotoxic agents

- overwhelming infections

Increased Peripheral Cellular Destruction

- SLE

- HIV infection

- hypersplenism

- paroxysmal nocturnal haemoglobinuria

THROMBOCYTOPAENIA

Pseudothrombocytopaenia

-> film

-> blue tube

Decreased Production

- bone marrow failure

- pernicious anaemia

Increased Destruction

- sepsis

- immune (ITP, TTP, HUS, HITTS)

- intravascular device (IABP, ECMO, PAC, bypass)

- drug induced (antibiotics, thiazides, H2 antagonists)

- antiphospholipid syndrome

- DIC

- HELLP

- haemolysis

Dilution

- post resuscitation

- massive transfusion

Jeremy Fernando (2011)