Blood Counts & Differentials
WBC (white blood cell count): nl=3.2 - 9.8
(leukopenia): autoimmune, bone marrow dysfunction, dilutional, hairy cell leukemia
(leukocytosis): acute phase reactant, bacterial infection, Hodgkin's disease, CML, ALL, AML
Hgb (hemoglobin): nl =13-17 =12-15
blood loss, anemia
hemoconcentration, dehydration, polycythemia vera, COPD
Hct (hematocrit): nl =39-49% =33-43%
blood loss, anemia
polycythemia vera, smoking, COPD, dehydration, hypovolemia.
(thrombocytopenia): SLE, heparin, NSAIDs, ITP, DIC, sepsis, marrow dysfunction, transfusion reaction, B12/folate deficiency, dilutional, ALL, AML.
(thrombocytosis): acute phase reactant (with infection). neoplasms, CML, polycythemia vera, postpartum, hemorrhage, hemophilia, iron deficiency, pancreatitis, cirrhosis.
N / (B) / L / M / B / E
|| in bacterial infection, demargination (acute phase reactant)|
in drugs (chemoTx), pancytopenias, malnutrition
|Bands:||only reported if present - indicate acute infection if 3% or greater|
|| in active or recent viral infection|
in HIV, SLE
|Monocytes:|| in wound healing (macrophages), infection (antigen presenters)|
|Basophils:||I have no idea what these are for.|
|Eosinophils:|| in fungal infection, allergic reaction|
aka "What the hell is a poikylocyte?"
- Acanthocytes: red cells with sharp irregular spicules: found in severe liver disease.
- Anisocytosis: normally red cells are all about the same size and shape. Unusual variation in size is anisocytosis.
- Basophilic stippling: round or irregular blue granules. Found in lead poisoning and hemolytic states.
- Burr cells: red cells covered with short uniform spicules. Found in severe uremia, hemolytic states.
- Crenated cells: See Burr cells.
- Echinocytes: See Burr cells.
- Elliptocytes: oval shaped red cells - found in some hemolytic states. May be hereditary.
- Heinz bodies: red cell inclusions representing precipitation of denatured hemoglobin. Found in association with unstable hemoglobin (hemoglobinopathies and some drug related hemolytic anemias). Demonstrated by supravital stains. Not seen in routine Wright stained smears.
- Helmet cells: resemble helmets and are attributed to the passage of red cells over fibrin strands in capillaries; are found in disseminated intravascular coagulation.
- Howell-Jolly bodies: red cells containing small nuclear fragments. Found in post-splenectomy states.
- Pappenheimer bodies: red cell inclusions representing hemosiderin granules. Are suspected in Wright stain smears when present as granules but are definitely identified by special (Prussian blue) stain for iron. Found in sideroblastic anemias.
- Poikilocytosis: excessive variation in red cell shape.
- Schistocytes: irregular fragments of red cells. Indicates red cell destruction.
- Spherocytes: normally red cells are biconcave discs. Spherical red cells are found in hereditary spherocytosis and some immune hemolytic anemias.
- Stomatocytes: red cells with central clear area in the shape of a slit or "mouth". Found in some congenital hemolytic anemias and in acquired liver disease.
- Target cells: these are thin red cells found in thalassemia and chronic liver disease. They have a red bull's eye center surrounded by a clear area followed by another red ring.