Blood morphology – how often to test? Adult morphology interpretation

Proven content

Blood count is the basic diagnostic test. Blood is a type of liquid connective tissue that circulates inside blood vessels. Blood is made up of morphotic elements such as red blood cells, white blood cells, and platelets.

Blood morphology

The blood consists of liquid plasma, which makes up about 55-60% of the blood volume, and the following morphotic elements:

1. red blood cells – erythrocytes
2. white blood cells – leukocytes
3. platelets – thrombocytes.

Blood functions

The human body has an average of 5-5,5 liters of blood. It has the following functions:

1. distributes oxygen around the body and carries carbon dioxide from the tissues to the lungs,
2. distributes nutrients, vitamins and hormones throughout the body,
3. discharges toxic or harmful substances into the excretory organs (kidneys, lungs, sweat glands),
4. takes part in the body’s defense against bacteria, viruses and other pathogens,
5. participates in maintaining a constant body temperature,
6. buffers, i.e. maintains a constant pH within certain limits.

The most frequently used basic diagnostic test is the test blood count. The blood count determines the patient’s health status and enables the diagnosis of inflammation, infection, anemia and many other disease processes.

The blood count does not include the determination of the hemoglobin level – however, taking into account the automation of the test process, this parameter is determined in parallel. The normal ranges for the complete blood count are listed below. However, it should be remembered that the results of laboratory tests depend on many factors and should not be considered in isolation from other elements of the diagnostic process. Therefore, the interpretation of the results is always best done by the attending physician.

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How to Interpret Adult Morphology Results?

1. Hematokryt (HCT)

Standard:

1. women: 37-47%
2. men: 42-52%

Elevated hematocrit levels can be caused by: an increase in the number of red blood cells – in the course of primary (polycythemia vera) and secondary hyperaemia (staying at high altitudes, chronic lung diseases, kidney cancer) and in dehydration (as a result of profuse diarrhea, persistent vomiting, diabetes insipidus) or as a result of excessive sweating, decreased plasma volume, peritonitis, extensive burns.

A decrease in hematocrit may be caused by: a decrease in the number of red blood cells – in the course of anemia, blood loss (bleeding), bone marrow diseases (radiation sickness, tumors), hyperhydration (too much water in the body)

2. Hemoglobina (HGB, Hb)

Standards:

1. women: 11,5-16,0 g / dl (7,2-10,0 mmol / l)
2. males: 12,5-18,0 g / dl (7,8-11,3 mmol / l)

The drop in hemoglobin is usually caused by anemia or fluid overload. On the other hand, an increased concentration of hemoglobin is observed in hyperemia and in disorders of the water and electrolyte balance (e.g. in dehydration).

3. White blood cells (leukocytes, WBC)

Standard:

1. 4,0-10,8 x 10⁹/l

We call the increase in the number of white blood cells leukocytosisand the decline – leukopenia. Leukocytosis can have physiological causes, such as high ambient temperature, sunbathing, pregnancy, exercise, stress. The increase in the number of white blood cells can also be caused by pathological factors, such as inflammation, tissue damage, infections, poisoning, and cancer.

Some infectious diseases, especially viral diseases, can cause a decrease in the number of white blood cells:

1. Hepatitis,
2. flu
3. HIV infection,
4. measles
5. rubella,
6. chicken pox.

Leukopenia also occurs in the case of bone marrow damage by ionizing rays, in aplasia and bone marrow hypoplasia, in cachexia, chemicals, collagen diseases, neoplastic bone marrow metastases, some leukemias and in the case of severe bacterial infections (sepsis, dura and paradura, shock anaphylactic).

4. Basophils (basophils, BASO)

Standard:

1. 0-0,2 x 10⁹/l

A high concentration of basophilia is observed in chronic inflammatory ailments of the gastrointestinal tract, Hodgkin’s syndrome, in people with chronic myeloid leukemia, in ulcerative enteritis and hypothyroidism.

Low levels of basophilia may appear in severe infections, acute rheumatic fever, hyperthyroidism, acute pneumonia and under stress.

5. Eosynophile (granulocyte kwasochłonne, EOS)

Standard:

1. 0-0,45 x 10⁹/l

Their high concentration causes:

1. allergic and infectious diseases,
2. hematological and parasitic diseases,
3. bronchial asthma,
4. hay fever, psoriasis,
5. taking certain medications (e.g. penicillins).

Reasons for the decline in eosinophils may include red blood, infection, sepsis, typhoid fever, injury, burns, exercise, and the effects of adrenal hormones.

6. Neutrophils (neutrophils, NEUT)

Standard:

• 1,8-7,7 x 10⁹/l

The increase in the level of neutrophilia is diagnosed in local and general infections, haematological infections, after trauma, haemorrhage, infarction, in cancer, in metabolic disorders, in heavy smokers and in women in the third trimester of pregnancy.

Low levels of neutrocytes are common in infections:

1. viral (e.g. rubella or flu),
2. fungal, bacterial (typhoid, tuberculosis, brucellosis),
3. protozoa (e.g. malaria)

High concentrations are also observed in the case of toxic damage to the bone marrow and during the treatment with cytostatics.

7. Lymphocytes (LYMPH)

Standard:

1. 1,0-4,5 x 10⁹/l

Their high level can be seen in the course of ailments such as rubella, whooping cough, multiple myeloma, mumps, tuberculosis, syphilis, measles, chronic lymphocytic leukemia and in people suffering from immune diseases. In turn, the decline, or pancytopenia, may be due to taking corticosteroids and a severe viral infection.

8. Monocytes (MONO)

Standard:

1. 0-0,8 x 10⁹/l

High levels of monocytes can be caused by:

1. typhoid,
2. endocarditis,
3. tuberculosis,
4. infectious mononucleosis,
5. Cancer,
6. protozoal infection,
7. syphilis,
8. trauma,
9. collagenoses,
10. brucellosis,
11. Crohn’s disease.

The decreased number of monocytes may be caused by an infection or the use of glucocorticosteroids.

9. Red blood cells (erythrocytes, RBC)

Standards:

1. women: 4,2-5,4 x 10¹²/l
2. males: 4,7-6,1 x 10¹²/l

The increase in red blood cells is, in short erythrocytosis, in turn, drop it erythropenia. Erythrocytosis (or polycythemia) is a rare condition that can be caused by a cancerous growth of red blood cells. It can also be caused by hypoxia or excessive production of the hormone that stimulates the production of red blood cells in the blood (erythropoietin).

However, we deal more often with anemia, sometimes caused by blood loss, vitamin B deficiency₁₂ or folic acid. Anemia also occurs in the case of the influence of various factors contributing to the breakdown of erythrocytes (then we are talking about hemolytic anemia). The cause of anemia is also a lack of adequate amount of iron or other secondary causes (pregnancy, kidney diseases, cancer, chronic diseases).

10. Platelets (thrombocytes, PLT)

Standard:

1. 130-450 x 10⁹/l

We encounter thrombocytosis in the case of inflammation (chronic), after heavy physical activity, in iron deficiency, after spleen removal, in pregnant women, in the course of some types of cancer. It also happens so-called essential thrombocythemia (for no apparent reason).

However, it is more common thrombocytopenia (thrombocypenia). It may be the result of, for example, vitamin B deficiency₁₂ or folic acid, infections, cancer, and other illnesses, and also present as a side effect of certain medications

Red blood cell volume distribution (RDW)

Standard:

1. 11,5-14,5%

This parameter increases in iron deficiency anemia. An increase in RDW can also be seen after blood loss or after vitamin B treatment₁₂ and / or folic acid.

Mean volume of red blood cells (MCV, ŚOK)

Standards:

1. women: 81-99 fl
2. men: 80-94 fl

An MCV value of less than 80 fl is indicative of microcytic anemia (accompanied by a reduction in the size of the red blood cell). It is characteristic of iron deficiency. On the other hand, a value of more than 110 fl is most often a signal of megaloblastic anemia associated with vitamin B deficiency.₁₂ and / or folic acid. A slight increase in MCV is sometimes caused by an increase in the number of reticulocytes (young forms of erythrocytes that have a greater volume), which is not always pathological.

Mean hemoglobin content (MCH)

Standard:

1. 27-31 pg

The increase in the mean content of hemoglobin in the red blood cell may accompany macrocytic anemia (vitamin B deficiency).₁₂ or folic acid). In turn, the decrease in the average hemoglobin content may be the result of water and electrolyte disturbances (e.g. hypotonic fluid overload) and hypochromic anemia (iron deficiency).

Mean hemoglobin concentration (MCHC)

Standard:

1. 33-37 g/dl

The increase in MCHC may be observed in patients with congenital spherocytosis and in states of hypertonic dehydration. On the other hand, the decrease in MCHC may be a consequence of water and electrolyte disturbances such as hypertonic hyperhydration and iron deficiency anemia.

Indications for performing a blood count

There are indications as to the type and scope of the tests performed determined individually by the attending physician. Complete blood count may also be associated with the prevention of certain diseases – then it is performed as a periodic test – once a year.

Blood counts can be performed even without a doctor’s order, but a medical consultation before and after the examination is recommended. There is no particular need to perform other tests in advance.

Blood morphology – preparation for the test

Blood counts can be performed at any time of the day or night. Unless your attending physician recommends otherwise, you can eat and drink before the examination. If we are taking any medications, there is no need to stop them. Due to some blood tests, you may need to follow a certain diet for several days before the test. Recommendations in this regard are determined individually with the attending physician and the laboratory performing the analyzes.

Description of the study

Blood for blood count testing is taken in a sitting position, and in particularly sensitive people – in a lying position.

Information to be reported prior to testing:

1. predisposition to bleeding (haemorrhagic diathesis)
2. tendency to faint when taking blood
3. data on currently taken medications.

How should you behave after the examination?

There are no special recommendations.

Possible complications after the examination

After the blood is drawn, there may be a slight bleeding or a hematoma at the point where the needle is inserted.

Text: lek. med. Matylda Mazur