.
5
y CBC y Dichlorophenol-indophenol precipitation test (DCIP) y
Osmotic Fragility test(OF) y Hemoglobin Typing
Red Blood Cellsy Oxygen y y
Hemoglobin RBC
Hemoglobiny
(heme) (globin) - 2 4 alpha ( gamma ( ) delta ( )
) beta ( )
Hemoglobiny
y Hb. A ( 2 2) y Hb. F ( 2 2) y Hb. A2 ( 2 2) y 3 y Gower1 ( 2
2) y Gower2 ( 2 2) y Hb. Portland ( 2 2)
3
HemoglobinHb y Hb Barts y Hb H
( 4) ( 4)
Hb
White Blood Cells 2 granule y granule Polymorphonuclear(PMN)
Neutrophil, Eosinophil Basophil y granule Monocyte, Lymphocytey
Neutrophil
Eosinophil
Basophil
Monocyte
Lymphocyte
Neutrophily y
y y band form
Eosinophil granule y y
Basophil granule y 1 (type I hypersensitivity) Histamine y
Monocytey
y y Macrophage y monocyte Multinucleated giant
Lymphocytey granule y
y
Plateletsy y
Megakaryocyte
CBC Complete Blood Count (CBC)
y Hb y Hct y WBC (N, L, E, B, M) y Platelet count y Red cells
morphology (or red cell indices)
HbHemoglobin(Hb)y y y Adult males : 13 - 18 gm% y Adult females
: 12 - 16 gm% y Pregnancy : 11 - 12 gm% y Newborn : 17 - 19 gm% y
Children : 14-17 gm%
Hemoglobin
gm%
HctHematocrit(Hct)y 3 Hb y y Adult males : 39 - 54 % y Adult
females : 36 - 48 % y Pregnancy : 33 - 36 % y Newborn : 54 - 57 gm%
y Children : 42 -51 gm%
Abnormal decreased Hb/Hcty y y y y y y
Hb
Hct
WBCWhite Blood Cells(WBC) y 5,000 - 10,000 cells / ml. y y
Neutrophils : 50 70% y Eosinophils: 1 4% y Basophils: 0.5% - 1% y
Lymphocytes: 25 - 40% y Monocytes: 2 - 8%
20,000
Abnormal high WBC WBC y Acute stress Neutrophil Band form y WBC
y Lymphocyte y Eosinophil
Abnormal low WBC WBC y y (Aplastic Anemia) Hct Platelet y SLE y
y
Platelety
1 ml. y 140,000 400,000 y 20,000 (Spontaneous hemorrhage)
Abnormal low platelet y y y (Disseminated Intravascular
Coagulation ; DIC) y (Idiopathic Thrombocytopenic Purpura ; ITP) y
(Hypersplenism) y
Red cell morphologyy Normochromic normocytic(NCNC) : (cental
pallor)
Red cell morphologyy Hypochromic microcytic :
Red cell morphologyy Anisocytosis :
Red cell morphologyy Poikilocytosis :
Red cell morphologyy Hypochromic microcytic y
Aniso-poikilocytotis
Red cell indices Automated y Mean Corpuscular Volume (MCV) y
Mean Corpuscular Hemoglobin (MCH ) y Mean Corpuscular Hemoglobin
Concentration (MCHC)
MCV MCV y : 80-90 cubic microns y : 82-98 cubic microns y
(Macrocytic) y MCV (Microcytic)
MCVnormal E1 trait E2 trait F trait Hb E trait Hb EE Hb H
disease F/E thal F thal MCV (fl) 85-95 70 + 8.7 85+5.5 68+6. 84+5.1
73+5.7 67+6.7 6 +5.6 55-65
MCH & MCHCy MCH picograms
29 2 g/dl
2
y MCHC g / dl 34
OF Osmotic Fragility test 0.36 y y 90 F thalassemia 93 E
thalassemia y
DCIP - Dichlorophenol-
indophenol precipitation test Hemoglobin DCIP y E 100
Globin
Hemoglobiny
y Hb. A ( 2 2) y Hb. F ( 2 2) y Hb. A2 ( 2 2) y 3 y Gower1 ( 2
2) y Gower2 ( 2 2) y Hb. Portland ( 2 2)
3
Hb
Globin Beta
y Thalassemia Alpha thalassemia
y Hemoblobinopathy Globin Hemoglobin E, Hemoglobin CS
y (Dominant) (Recessive)
y (Genotype)
y (Phenotype)
( ) ( ) ( ) ( ) (Homozygous)
y -- alpha 1 y yy
CS
alpha 2 Hb CS
y yN
y E0
Hb E
Genotype --/EE -E /EE --/-E -- /-F0 / F F0 / FE F0/ F0
PhenotypeAlpha 1 trait Alpha 2 trait Hb H Disease
Hb Bart s hydrops fetalisF0 Thalassemia trait F0 Thal/Hb E
Homozygous F0
y A2A Hb A Hb A2 2.5 y Hb A2 3.5 F thalassemia y Hb
electropheresis Hb E Hb A2 Hb E Hb A2 15 Hb E y Hb E Hb E 25-35 Hb
E 25 E thalassemia
Hb typing
y Hb E homozygous Hb E 85 y Hb Bart s Hb H E thalassemia Hb H
disease y Hb constant spring (Hb CS) Hb CS 1-2 homozygous Hb CS Hb
CS 510 y E1 Hb typing MCV y E2 ( ) Hb H disease E1 E2 E
y A2A, A2 > 3.5% y A2A y A2F y EFA y A2A Bart s H
y EA , E = 40% y EE , E = 85%
Indications for prenatal diagnosisy Hb Bart s hydrops fetalis y
Homozygous Beta Thal. y Beta Thal / Hb E
PNDEA (E = 35%) A2A Bart s H A2A (A2 = 5%) EF EA (E = 30%)
EE (E = 85%) A2A (A2 = 2%) EA (E = 30%) A2A (A2 = 4%) A2A Bart s
H
1 EA (E = 35%) EE (E = 85%)y y
E trait Homozygous Hb EFE FE/FE FE/FE
F FE FE F/FE F/ FE
2 A2A Bart s H A2A (A2 = 2%)y y
Hb H disease --/-E -EE EE EE / -EE / --
-EEE / -E EE / -E
3 A2A (A2 = 5%) EA (E = 30%)y y
Beta thal. trait E traitF0 F/F0 F0/FE
F F FE F/F F/FE
4 EF A2A (A2 = 4%)y y
Beta thal / Hb E Beta thal traitF0 F F0 F/F0 F0/F0 FE F/F
F0/FE
5 EA (E = 30%) A2A Bart s Hy y
E trait (F/FE) Hb H disease (--/-E)
Any question?
