• WBC (white blood cell count)
  • decreased:
    • neutrophiles: 1000-1500 is borderline neutropenia (and should be infection competent [CP10-16]; 500-1000 is neutropenia (risk of infection) & <500 has a severe infection risk.
  • increased: there is a tendency among Jews & Melungeon (mixed American Indian, black & white...tri-racial) people to run an elevated total WBC & a proportion may reflect "familial Mediterranean fever" [FMF...a cause of night sweats, fever]).
• RBC (red blood cell count)
  • decreased (a softer definition of anemia)
  • increased
• HGB (hemoglobin, total blood level)
  • decreased (the prime definition of anemia)
  • increased
• HCT (hematocrit)
  • decreased (a softer definition of anemia)
  • increased
• MCV (mean red-cell corpuscular volume)...normal 76-99
  • decreased (microcytosis...typically reflects abnormal HBG synthesis))
  • normal range (normocytic)
  • increased (macrocytosis...typically reflects abnormal nuclear maturation)
• MCH (mean red-cell corpuscular volume)
  • decreased
  • increased
• MCHC (mean red-cell corpuscular HGB concentration)
  • decreased (hypochromic)
  • not decreased (normochromic)
• RDW  (red-cell
  • not increased (homogeneous RDW)
  • increased (heterogeneous RDW)
• PLT (platelet count)
  • decreased (thrombocytopenia):
    1. consumptive (as in ITP) has enlarged platelets & increased marrow megs (can be sure of hyperplasia when see megs side-by-side) & may or may not have splenomegally (ITP usually not enlarged spleen).
    2. hypoproduction has small platelets (very few larger ones) & no marrow meg hyperplasia & usually no splenomegally.
  • increased (thrombocytosis)
    • primary: myeloproliferative syndrome & myelodysplastic syndrome
    • secondary

• MPV (mean platelet volume)
• WBC DIFFERENTIAL COUNT:
  • % and/or quantity of lymphocytes
  • % and/or quantity of monocytes
  • % and/or quantity of neutrophiles, segs
  • % and/or quantity of neutrophiles, bands
  • % and/or quantity of neutrophiles, metas
  • % and/or quantity of neutrophiles, promy
  • % and/or quantity of neutrophiles, myelos
  • % and/or quantity of eosinophiles
  • % and/or quantity of basophiles
• CBC morphological clues (where no links to images), search the term in Google's image search engine.
  • RBCs:
    • parasites, intra-erythrocytic (Google images or check ref. #3 HERE):
    1. babesiosis: malaria-like bodies;the screening test is from a CBC EDTA tube and ordered as "smears for parasites "
    2. malaria: the screening test is from a CBC EDTA tube and ordered as "thick & thin smears for malaria".
    3. ehrlichiosis:
    4. borreliosis:
    5. trypanosomiasis (Chaga
    • sickle cells
    • elliptocytes (cigar cells)
    • acanthocytes
    • echinocytes
    • target cells
    • microcytes
    • macrocytes
    • ovalocytes
    • puzzlecytes
    • pyknocytes
    • pyropoikilocytosis: a mix of elliptocytes, teardrops, spherocytes & microspherocytes (micropoikilospherocytes)
    • teardrop cells
    • spherocytes
    • stomatocytes: when very exaggerated = purse cells; due to gain of red cell solute & water.
    • xerocytosis: a loss of red cell solute & water so that RBCs have variably dense areas and pale areas
  • WBCs:
    • neutrohil series:
    1. anaplasmosis: looks almost like an engulfed platelett.
    2. ehrlichiosis:looks almost like an engulfed platelett.
    • lymphocyte series:
    • monocyte series:
    • morula in Ehrlichiosis
  • Platelets:

References:

1. "Pearls", W. R. Armstrong, M. D., board-certiied, our long-time hematopathologist.
2. "Pearls", John B. Carter, M. D., our long-time practitioner of hematopathology who trained under Dr. Brunning & along with Dr. McKenna, above.
3. Blevins SM, "Blood Smear Analysis...", Cleveland Clinic Journal of Medicine, 75(7):521-530, July 2008.

(posted 2002; latest addition 6 September 2011)