CBC - Complete Blood Count
Complete Blood Count
Whole blood is made up of various types of cells suspended in a liquid called plasma. The complete blood count (CBC) is an inventory of the different cellular components of the blood: red blood cells, white blood cells, and platelets. Blood cell counts are typically reported as the number of cells in a cubic millimeter of blood (cells/mm3) or as a percentage of all blood cells.
Red Blood Cells
Red blood cells (erythrocytes) carry oxygen from the lungs to the body's cells, bound to a molecule called hemoglobin. Anemia is a condition characterized by a reduction in the number of red blood cells, often leaving a person fatigued, weak, and short of breath. Several tests are used to help diagnose various types of anemia.
Red Blood Cell Count (RBC): the total number of red blood cells in a quantity of blood. Normal ranges are 4.5-6.0 million cells/mm3 for men and 4.0-5.5 million cells/mm3 for women. (Women typically have lower counts than men due to the loss of blood through menstruation.)
Hematocrit (HCT): the proportion of red blood cells as a percentage of total blood volume. A normal hematocrit is 40-55% for men and 35-45% for women. This screening measures how much of your blood is made of red blood cells (RBCs). A hematocrit measurement is useful in identifying anemia, the presence of liver disease, bleeding disorders and red cell production within the circulatory system. Hematocrit increases with altitude adaptation or dehydration. Women generally have lower hematocrit values than men. Some men on testosterone therapy have high hematocrit that can be managed if monitored.
Hemoglobin (HGB): the number of grams of hemoglobin in a deciliter of blood (g/dL). Normal levels in healthy adults are 14-18 g/dL for men and 12-16 g/dL for women. As a rough guideline, hemoglobin should be about one-third the hematocrit. Hemoglobin is an iron-containing protein found in red blood cells (RBCs), enabling the cells to carry oxygen and carbon dioxide in the blood. Measuring hemoglobin gives a picture of the ability of the blood to carry oxygen to every cell of your body. A low hemoglobin level may indicate anemia. Hemoglobin increases with altitude adaptation. In general, women have lower hemoglobin values than men.
Mean Corpuscular Hemoglobin (MCH) and MCH Concentration (MCHC): the amount or concentration, respectively, of hemoglobin in an average red blood cell. Mean corpuscular hemoglobin (MCH) is a calculation of the amount of oxygen-carrying hemoglobin inside your red blood cells (RBCs). A high MCH indicates an increased level of hemoglobin, the oxygen-carrying protein, in your RBCs. Increases can be associated with anemia. Often, increased MCH occurs in conjunction with a high mean corpuscular volume—or large red blood cells-which suggest macrocytic anemia. A low MCH indicates that you have a decreased level of oxygen-carrying protein in your red blood cells. Decreases can be associated with certain types of anemia. Often, decreases occur in conjunction with low mean corpuscular volume—or small RBCs—which suggest microcytic anemia. Hypochromic anemia, resulting from hemoglobin deficiency, can be a possibility as well.
Mean corpuscular hemoglobin concentration (MCHC) is the calculation of the percentage of oxygen-carrying hemoglobin in the individual red blood cells (RBCs). A high MCHC indicates an increased level of hemoglobin in your RBCs. Increased MCHC is usually a technical rather than a medical issue. A high level may be caused by distortions in the shape of your RBCs caused by problems in collection, transport or storage of the blood sample. A low MCHC indicates a decreased level of hemoglobin in your RBCs. Decreases can be associated with certain types of anemia, such as iron-deficiency or the hereditary disease, thalassemia.
Mean Corpuscular Volume (MCV): the average size, or volume, of individual red blood cells. Conditions such as iron deficiency can lead to smaller than normal red blood cells, while certain vitamin deficiencies and some drugs can produce larger than normal cells. Mean corpuscular volume (MCV) is a measurement of the average size of your red blood cells (RBCs). A high MCV indicates large, or macrocytic, RBCs. A high MCV is associated with specific varieties of anemia and can indicate a deficiency in vitamin B12 or folic acid. A low MCV indicates small, or microcytic, red blood cells. A low MCV is associated with anemia, and can indicate an iron deficiency, chronic illness or the hereditary disease, thalassemia.
Red Blood Cell Distribution Width (RDW): a measure of the size and uniformity of red blood cells.
White Blood Cells
White blood cells (WBCs) are the body's protectors. Each of the five varieties of WBCs plays its own specific role in defending your body against illness or injury.
White blood cells (leukocytes) carry out the body's immune responses. The CBC looks at numbers of various different types of white blood cells.
White Blood Cell Count (WBC): the total number of white blood cells in a quantity of blood. A healthy adult normally has 4,000-11,000 white blood cells/mm3. A WBC increase often indicates that a person is actively fighting an infection or has recently received a vaccine. Decreased WBC (leukopenia) can leave a person vulnerable to various pathogens and cancers.
Differential: a report of the proportions of different types of white blood cells as a percentage of the total number of white cells; these percentages may be multiplied by the WBC to obtain absolute counts.
Neutrophils: a type of cell that fights bacterial infections. Neutrophils normally make up about 50-70% of all white blood cells. The risk of bacterial infection increases when the absolute neutrophil count falls below about 500-750 cells/mm3. Neutrophilic granulocytes (“neutrophils”) are the most abundant white blood cell. Neutrophils are an essential component of the immune system. They respond to bacterial infections and other types of inflammation. In an infection, neutrophils seep out of the blood vessels in response to factors released as sites of infection. The predominant cells in pus that we observe in a wound are neutrophils.
Lymphocytes: there are two main types of lymphocytes. B cells produce antibodies that fight foreign invaders in the body, while T cells target infected or cancerous cells and help coordinate the overall immune response. A normal lymphocyte count is about 20-40% of all white blood cells. Lymphocytes are the second most common white blood cell (WBC). Lymphocytes are divided into larger cells that are also known as natural killer lymphocytes and smaller cells known as B and T lymphocytes. Natural killer cells are important in our immune system to defend against tumors and viral infections. They respond to alterations in the surface of tumor cells and infected cells. B and T lymphocytes adapt to infected cells by either a cellular response mediated by T lymphocytes or antibodies mediated by B lymphocytes.
Monocytes: a type of cell that fights pathogens by engulfing and destroying them. Monocytes circulate in the blood for about 24 hours; when they leave the bloodstream and migrate into the tissues, they mature into macrophages. Monocytes and macrophages normally account for 2-10% of all white blood cells. Monocytes, like the other white blood cells (WBCs), originate in the bone marrow, the complex spaces within many of our larger bones. Monocytes are responsible for eating foreign intruders (phagocytosis) and killing infected cells. Monocytes are important in triggering atherosclerosis that affects our arteries and can lead to heart disease and stroke.
Eosinophils: cells that play a role in defense against parasites and in allergic reactions. They normally make up 0-6% of all white blood cells. Eosinophilic granulocytes (“eosinophils”) are part of our immune system’s response to infection including from parasites. Eosinophils, along with basophils and mast cells, are important in allergic responses and in asthma.
Basophils: another type of cell involved in allergic reactions, in particular the release of histamine. They normally account for 1% or less of all white blood cells. Basophilic granulocytes (“basophils”) - are the least common of the five white blood cell types. When activated, basophils secrete or release many compounds including histamine and interleukin-4. Both compounds are important in the allergic response.
Platelets (thrombocytes) are necessary for blood clotting. A normal platelet count is about 130,000-440,000 cells/mm3. Low platelet counts (thrombocytopenia) -- which can lead to easy bruising and excessive bleeding -- may be caused by certain drugs, autoimmune reactions, accelerated destruction by the spleen, or certain immune diseases. Platelets are the smallest type of cell found in the blood. Platelets help stop bleeding after an injury by gathering around the injury site, plugging the hole in the bleeding vessel and helping the blood to clot more quickly. Platelet counts may be done if you are prone to bruising or if you are about to have surgery. The platelet count may change with bleeding disorders, heart disease, diabetes and inflammatory disorders.
MPV stands for Mean Platelet Volume. Platelet volume varies with the age of the platelets. Newer platelets are larger than older ones.
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