Synonyms

   Complete Blood Count (CBC), Blood for Complete Picture (Blood for CP), Full Blood Count (FBC)

Clinical Significance

   Haemogram is a common blood test that is often part of a routine checkup. Blood is composed of red blood cells (RBC), white blood cells (WBC) and platelets (Plt) suspended in the fluid medium called plasma. A haemogram test measures quantitative count and qualitative data of RBC, WBC, and Platelet. Haemogram is useful in variety of clinical setting as in diagnosing anemia, infections, acute hemorrhagic states, hematological malignancies, allergies, and immunodeficiencies. Also it is used for monitoring side effects of certain drugs.

Specimen

   Whole blood 1ml or 3ml

Stability

   24 hours at 20 - 25 ˚C

   72 hours at 2 to 8 ˚C

   7 days at -20 ˚C

Reference Range

Interpretation

White Blood Cell (WBC)

   WBCs aslo known as leukocytes or granulocytes are part of the body's immune system. They help the body fight infection and other diseases. WBC test includes Total and Differential WBC count, the typing of the white blood cell into five major granulocytes called neutrophil, eosinophil, basophil, lymphocyte and monocyte.

   Increased Total WBC count generally means:

       Infection or inflammation in somewhere of your body

       Bone marrow disease, causing abnormal production of white blood cells

       Immune system disorder that increases white blood cell production

       A reaction to a drug that increases white blood cell production

   Decreased Total WBC count may be due to:

       Viral infections that temporarily disrupt the work of bone marrow

       Autoimmune conditions that decrease WBC production

       Malnutrition or vitamin deficiencies

       Cancer or other diseases that damage bone marrow

       Radiation treatments for cancer

       Chemotherapy

       Aplastic anemia

Neutrophil

   Neutrophils are a type of white blood cell functioning to fight against infection. Causes of increased neutrophil count, as known as neutrophilia or neutrophil leukocytosis are

   Primary causes

       Chronic myelogenous leukemia.

       Juvenile myelomonocytic leukemia (JMML)

       Chronic neutrophilic leukemia

   Secondary causes

       Acute infection

       Acute inflammation

       Chronic inflammation

       Physical or emotional stress

       Injuries such as breaking a bone

       Reactions to tumors

       Reaction to medication

       Smoking cigarettes

       Vigorous exercise

   Decreased neutrophil count, referred to as neutropenia can be caused by the following:

       Genetic conditions

       Infections such as HIV, hepatitis, tuberculosis, sepsis, and Lyme disease, etc

       Cancers

       Bone marrow disorders, including leukemia and lymphoma

       Chemotherapy and radiation therapy can harm or destroy neutrophils and/or the bone marrow that makes neutrophils as a side effect.

       Some medications

       Nutritional deficiencies such as vitamin B12 or folate

       Autoimmune diseases

Eosinophil

   Eosinophils are a variety of white blood cells (WBCs) and one of the immune system components responsible for combating multicellular parasites and certain infections. Along with mast cells and basophils, they also involve in mechanisms associated with allergy and asthma.

   An increase in eosinophils is called an eosinophilia, and is typically seen in

       Parasitic infestation of the intestines

       Allergic condition such as asthma

       Autoimmune and collagen vascular disease (such as rheumatoid arthritis)

       Systemic lupus erythematosus

       Malignant diseases such as eosinophilic leukemia, clonal hypereosinophilia, and Hodgkin's disease

       Lymphocyte-variant hypereosinophilia;

       Extensive skin diseases (such as exfoliative dermatitis)

       Medications such as penicillin

   Lower number of eosinophil called eosinopenia can be caused by

       bacterial infection

       Stress reactions

       Cushing's syndrome

       Use of steroids

Basophil

   Basophils are the least common type of granulocyte, representing about 0.5% to 1% of circulating white blood cells. However, they are the largest type of granulocyte. They are responsible for inflammatory reactions during immune response.

   Basophilia or increased basophil count is linked to the following conditions:

       Fighting a serious medical condition like hyperthyroidism or cancer

       Persistent infection

       Fending off an allergen

       Acute and chronic allergic diseases , including anaphylaxis, asthma, atopic dermatitis and hay fever

       Acute myeloid leukaemia

       Chronic myelogenous leukaemia

       Autoimmune disease such as rheumatoid arthritis, multiple sclerosis

       Myelofibrosis

   A low basophil level is called basopenia. It can be caused by

       Infections

       severe allergies

       an overactive thyroid gland

Lymphocyte

   Lymphocyte is a type of white blood cell. It includes natural killer cells,T cells and B cells They are the main type of cell found in lymph, which prompted the name lymphocyte.

   An increase in lymphocyte concentration is seen in

       Viral infection

       Inflammation

       A high lymphocyte count with a low neutrophil count might be caused by lymphoma.

       Patients undergone splenectomy

       Cancers

   A low lymphocyte concentration is associated with the following:

       Human immunodeficiency virus (HIV) infection

       Covid 19 infection

       Undernutrition

       Aplastic anemia

       Autoimmune diseases

Monocyte

   Monocytes are the largest type of leukocyte in blood and can differentiate into macrophages and conventional dendritic cells. As a part of the innate immune system monocytes also influence adaptive immune responses and exert tissue repair functions.

   Monocytosis or increased monocyte level is common in

       Bacterial infections such as tuberculosis5

       Viral infections such as COVID-19

       chronic inflammatory diseases, such as inflammatory bowel disease

       Due to splenectomy (removal of the spleen

       leukemia and other types of cancer, including lymphoma and multiple myeloma

       Primary myelofibrosis

   Low level of monocyte (monocytopenia) is associated with

       Chemotherapy

       Radiation therapy

       HIV and AIDS

       sepsis, an infection of the bloodstream

Immature Granulocyte Count (IG)

   Typically granulocytes fully develop in bone marrow before entering into bloodstream. If immature granulocytes are found in the circulation, it could mean that there's a problem with the bone marrow. Or, it may simply indicate an early-stage response to infection. IG (immature granulocytes) above 1% may indicate infections or chronic inflammation. IG could also be elevated in other conditions like inflammatory or cancerous diseases and in pregnancy.

Red Blood Cells (RBC)

   Red blood cells (RBCs), also referred to as red cells, erythroid cells or erythrocytes, are the most common type of blood cell and function as oxygen transporter to the body tissues via circulatory system. The cytoplasm of a red blood cell is rich in hemoglobin, an iron-containing biomolecule that can bind oxygen and is responsible for the red color of the cells and the blood. RBC tests include the following parameters:

       Haemoglobin (Hb): amount of haemoglobin (oxygen-carrying protein) in whole blood

       Haematocrit (Hct): percentage of the blood sample that is made up of red cells

       Mean corpuscular volume (MCV): the average size of the red cells present in the blood sample

       Red cell distribution width (RDW): a range from the largest red cell present to the smallest red cell present

       Red cell count (RCC): the number of red cells present per unit volume of blood

       Reticulocyte count: the number of reticulocytes (immature red cells)

       Mean corpuscular haemoglobin (MCH): the amount of haemoglobin per red blood cell

       Mean corpuscular haemoglobin concentrate (MCHC): average concentration of haemoglobin in a given volume of blood

   Increased RBC count may be caused by a number of health conditions:

       congenital heart disease

       dehydration (for example, from severe diarrhoea)

       low blood oxygen levels (hypoxia)

       Polycythemia vera

       pulmonary fibrosis (a lung condition that causes scarring of the lung

   Decreased RBC count (also known as anaemia) may be due to:

       Iron deficiency

       Vitamin B6, B12 or folate deficiency

       Kidney disease

       Malnutrition

       Internal bleeding

       Hemolysis

       Infection

       Cancers causing bone marrow suppression

       Aplastic anemia

       Thalassemia

       Pure red cell aplasia

Platelet (PLT)

   Platelets, as known as thrombocytes are a component of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping, thereby initiating a blood clot.

   Platelet tests include:

       Platelet count: the total number of platelets

       Mean platelet volume (MPV): the average size of platelets

       Platelet distribution width (PDW): measures variability in platelet size

   Increased platelet count (also called thrombocytosis) can be can be primary or secondary.

   Primary thrombocytosis is a disease in which abnormal cells in the bone marrow cause an increase in platelets. The cause is unknown.

   Secondary, or reactive, thrombocytosis is caused by any underlying condition the patient may be suffering from, such as:

       Anemia due to iron deficiency

       Cancer

       Inflammation or infection

       Surgery, especially splenectomy

       Chronic myeloproliferative disorders

   Decreased platelet count (also known as thrombocytopenia) can be due to

       Leukemia and other cancers

       Some types of anaemia

       Viral infections

       Chemotherapy drugs

       Radiation therapy

       Heavy alcohol consumption

       Immune thrombocytopenia

       Hemolytic uremic syndrome

Blood film

   A blood film is typically used as a follow-up test to abnormal results on a complete blood count (CBC) to evaluate the different types of blood cells. Visual examination of a blood film provides a clear picture of these abnormalities prompting further testing to determine the cause. The results of a blood film typically include a description of the appearance of the red blood cells, white blood cells, and platelets as well as any abnormalities that may be seen on the slide.

   A blood film can be used to help diagnose

       Anemia, such as iron deficiency anemia, hemolytic anemia, aplastic anemia, sickle cell anemia

       Malaria infection

       Certain blood cell cancers

Limitation

   There are several reasons why blood cell levels are not in the normal range. Any abnormal level of blood cells does not always mean a medical condition that needs treatment. Diet, activity level, medicines, a menstrual period, pregnancy, not drinking enough water, and other factors can affect the results. The results are taken into consideration with the results of other laboratory tests as well as clinical signs and symptoms.