Red Blood Cell
Protocols
HYPOCHROMIA (Increase in central pallor)
• Iron deficiency anaemia
• Thalassaemia
• Sideroblastic anaemia
• Anaemias of chronic diseases
MACROCYTES
(Larger than small lymphocytes)
• Myeloblastic anaemia
• Hepatic disease
• B deficiency
• Aplastic anaemia
• Congenital dyserythropoietic anaemia
• Pure red cell aplasia
TARGET CELLS
• Obstructive liver disease
• Thalassaemia
• Haemoglobin ‘C’ disease
• Haemoglobin ‘D’ disease
SPHEROCYTES
• Hereditary spherocytes
• Autoimmune haemolytic anaemia
• Cl. welchii infection
• Post-burn patients
LEUCOERYTHROBLASTIC PICTURE
(Immature myeloid and erythroid cells
appearing in peripheral blood)
• Myeloproliferative disorders:
– Polycythemia vera
– Myelofibrosis
• Haemolytic anaemias
• Leukaemias
• Bone marrow involvement with Hodgkin’s
carcinoma or lymphoma
• Leukaemoid reactions.
RETICULOCYTE COUNT
Stained with brilliant cresyl blue appears as bluish
strands in cytoplasm due to precipitation of ribosomes
and RNA.
(Normal 0.1-2%).
Increased
• Haemolytic anaemia
• Nutritional anaemia on therapy
Reduced:
-Aplastic anaemia
• PNH.
INCREASED PLASMA HAEMOGLOBIN
(Normal 0.4 mg/100 ml)
• G6 PD deficiency
• PNH
• Black water fever
• Cold haemoglobinuria
• Autoimmune haemolytic anaemia.
LEUCOCYTE ALKALINE
PHOSPHATASE SCORE
Increased
• Infection
• Leukaemoid reaction
• Myelofibrosis
• Aplastic anaemia
• Polycythemia vera.
Decreased
• Chronic myeloid leukaemia
• Paroxysmal nocturnal haemoglobinuria.
COOMB’S TEST
It is positive in autoimmune haemolytic anaemia
i. Idiopathic.
ii. Secondary to
• Lymphoma
• Infectious mononucleosis
• Mycoplasma pneumonia
• Cold agglutinin disease
ESR raised
• Pregnancy from 4th month
• Anaemia (except sickle cell)
• Acute myocardial infarction
• Carcinomatosis
• Pulmonary tuberculosis
• Acute gout
• Extensive tissue damage-burns
• Acute infections
• After fracture and operation.
ESR very rapid increase
• Temporal arteritis
• Kala-azar
• Some cases of multiple myeloma
• Rheumatoid arthritis
• Leukaemia
• Haemolytic anaemia
• Chronic renal disease
• Sarcoidosis
ESR decreased
• Polycythaemia vera
• Congestive cardiac failure
• Whooping cough, dehydration.
COAGULATION TIME
Normal values for clotting time are 9-15 minutes.
Reduced
• After meals
• In typhoid
• After haemorrhage and general anaesthesia
• In endocarditis
• After splenectomy.
Prolonged
• In haemophilia A, B, and Factor XI deficiency
• Obstructive jaundice
• Chloroform and phosphorus poisoning. Here the
fibrinogen forming function of liver in hampered
• Excessive CO2 in blood
• Occasionally in leukaemia.
HCT: increase
1. Plasma
Leakage (eg. In Dengue)
2.
Polycythaemia Rubra Vera (>0.52
males, >
0.48 females)
3. True'
polycythaemia (-Absolute
erythrocytosis)
Males >
0.60
Females >
0.56
4. Relative
erythrocytosis
Diuretics
Smoking
Obesity
Alcohol
excess
Gaisbock's
syndrome
HCT: decrease
Anaemia
↑MCHC: Increase
1. Severe
prolonged dehydration.
2. Hereditary
spherocytosis.
3. Cold
agglutinin disease.
|
MCHC: decrease
1. Iron
deficiency anaemia.
2.
Thalassaemia.
MCV (Macrocytosis):
1. B12 or
folate deficiency
2.
Myelodysplasia
Note:
Spuriously raised in cold
agglutinins,
non-ketotic hyperosmolarity
MCV (Microcytosis)
1. Iron
deficiency
2.
Thalassaemia traít
3.
Sideroblastic anaemia
MCV normal (in anaemia)
1. Blood loss
2. Anaemia of
chronic disease