Hematologic studies comprise a suit of research activities that are performed to obtain information on the quantitative and qualitative composition of blood cell elements.
Clinical blood analysis (complete blood count) is a set of tests which serves to determine quantities of various blood cells, their parameters (dimensions, etc.) and characteristics that reflect their proportions and functions. As a rule, 8 to 30 parameters are included into complete blood count study: estimation of erythrocyte, leukocyte and thrombocyte content in 1 microliter or liter of blood, as well as assessment of a number of other indicators that describe the form, volume and other properties of these cells, estimation of the Arneth formula (percentage of different forms of leukocytes), as well as determining the erythrocyte sedimentation rate (ESR).
INDICATIONS FOR COMPLETE BLOOD COUNT
- Identification of infections, inflammatory processes and malignant neoplasms;
- Assessment of the effectiveness of the appointed treatment.
- Planned examinations.
OUR LABORATORY PERFORMS:
- Complete blood count including nuclear Arneth's index estimation (blood smear microscopy)
- Complete blood count including nuclear Arneth's index estimation + reticulocyte count
- Reticulocyte count (automated RET analysis)
- Manual thrombocyte count
- Fluorometric thrombocyte analysis (automated count)
- Complete blood count including nuclear Arneth's index estimation
- Microscopic study to estimate the nuclear Arneth's index (blood smear microscopy)
- Erythrocyte sedimentation rate estimation according to the Westergren method
Complete blood count, nuclear Arneth's index estimation and thrombocyte and reticulocyte estimation are performed at the automatic analyzer XN 1000 made by Sysmex Corporation, Japan.Interpretation of complete blood count data
- White blood cell count including nuclear Arneth's index estimation. White blood cells are cells that help the body combat infections. These blood cells are able to identify foreign invaders (bacteria and viruses) within the body, and to destroy them. Five types of leukocytes are distinguished: eosinophils, basophils, neutrophils, lymphocytes and monocytes. These cells are determined as part of the nuclear Arneth's index estimation (estimation of the composition of different types of leukocytes within the blood serum and of their number in a unit of volume). All the parameters of the nuclear Arneth's index estimation, including immature granulocyte count, are determined using the fluorescent flow cytometry technique. This analysis makes it possible to determine an extended list of clinically significant parameters during each analysis procedure. Assay sensitivity is of especial importance in the detection of inflammatory and infectious diseases. Total leukocyte number is, most commonly, increased during an acute infection process caused by bacteria. If there is an insufficient number of leukocytes, the body is more liable to various infections. This parameter is also helpful for therapy monitoring -- if a increased number of leukocytes starts to decrease this evidences an effective treatment.
Normal values: (4-9)x109/l
- Number of erythrocytes
(red blood cells) Erythrocytes are cells that have hemoglobin as their component. Complete blood count helps to determine whether there are enough erythrocytes in blood, as well as their form, dimensions and hemoglobin content (MCV, MCH, MCHC). If the number of erythrocytes estimated during a complete blood count is too low, this means the patient is affected by anemia. This may be manifested by weakness, easy fatigability and labored breathing. An increased number of total erythrocytes (erythrocytosis, or polycythaemia) is encountered less often.
Norm: in women -- (3.7-4.7)x1012/l, in men -- (3.9-5.1)x1012/l
- Hemoglobin content
(Hb). Hemoglobin is the protein which contains iron, and is able to transfer oxygen from lungs to tissues and organs, and carbon dioxide -- from tissues and organs to lungs from where it is exhaled. Hemoglobin defines the main function of erythrocytes and its content determines the color of these blood corpuscles.
Norm: in women -- (120-150)g/l, in men -- (130-170)g/l
- Hematocrit (Hct) determines the volume of erythrocytes in blood within the blood stream. This indicator is expressed in percentage. The content of hematocrit grows when the number of erythrocytes increases or when the blood plasma level decreases, which happens when the body loses liquid in excessive quantities (e.g., in cases of diarrhea). Conversely, a decrease of this indicator is noticed if the number of erythrocytes decreases (e.g., due to their destruction or reduced generation) or in cases of overhydratation, i.e., when an individual’s body receives too much liquid (e.g., in cases of administration of excessive quantities of intravenous solutions). Hematocrit reflects not only the quantity of erythrocytes but also their dimensions. If the size of erythrocytes decreases (e.g., in cases of iron-deficiency anemia), hematocrit value also declines.
Norm: in women -- (33-46)%, in men -- (38-49)%
- Erythrocyte indices
determine the size of erythrocytes and their hemoglobin content, and include the mean corpuscular volume (MCV), mean cell hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), as well as the red cell distribution width (RDW). Estimation of the above characteristics is an integral part of a complete blood count and is not performed separately.
Normal values: MCV - (80-98)fl, MCH - (27-37)pg, MCHC - (300-360)g/l, RDW - (11.5-14.5)%
- Thrombocytes (platelets, PC, PLT) are cells that play a major role in blood clotting. If an individual has a decreased platelet count, they are at an increased risk of bleeding and bruising.
Thrombocytopenia is a condition marked by an abnormally low platelet level, below that of the adult thrombocyte level norm. A severe form of thrombocytopenia with the level of platelets lower than 20 x 109 /l may lead to the a spontaneous (non-traumatic) bleeding. Ignoring the symptoms of severe thrombocytopenia may have serious repercussions to the patient. For this reason, accurate count results are essential for making crucial clinical decisions. At the same time, ensuring an exact platelet count, especially based on patient’s thrombocytopenia specimens, is a laboratory challenge. The XN 1000 station made by Sysmex offers an effective platelet count solution in the form of fluorometric platelet analysis. This technique makes it possible to measure not only standard indicators, but also specific markers, e.g., immature platelet fraction. This is a more precise indicator of platelet formation which reflects the immature platelet fraction of their total number. This is also the value used by physicians to determine the reason of thrombocytopenia based on the etiology of various congenital and acquired thrombocytopenic conditions.
Normal values: (150-9)x109/l
(RET) are young forms of erythrocytes that are formed in the bone marrow and are present in blood in small numbers. This indicator enables the assessment of the functional status of the red blood cell formation. An increased number of reticulocytes is an indicator of an active blood formation in the bone marrow during hemolytic anemia or following a blood loss, and its drop is a characteristic indicator of hypoplastic anemia.
Automated reticulocyte analysis offers exclusive possibilities for a comprehensive erythrogenesis assessment. To estimate reticulocyte content, the fluorescent flow cytometry, a method whose accuracy is globally recognized, is used. The analysis reflects a wide array of reticulocyte-related parameters -- both qualitative and quantitative -- to facilitate the development of a comprehensive view of the red blood cell formation. Apart from that, it enables in-process monitoring of iron and/or erythropoetin therapy which offers better patient recovery prospects, and is used for differential anemia diagnostics and therapy effectiveness monitoring. Along with total reticulocyte count, the station performs their fractionation depending on maturity and, consequently, erythropoietic activity. Additional insights into the qualitative characteristics of immature platelets may be gained through the evaluation of hemoglobin reticulocyte hemoglobinization level, which is a useful advanced clinical parameter for therapy of patients affected by iron deficiency or anemia. Apart from the above, RET analysis offers information on the content of hypochromic and hyperchromic erythrocytes, as well as erythrocyte fragments.
Normal values: (1.03-1.85)%
- Erythrocyte sedimentation rate (ESR) An increased ESR is a non-specific indication of an inflammatory condition. With a decreased erythrocyte count, ESR is increased regardless of the nature of anemia. Decreased ESR is observed in polycythaemias of various etiology. The reaction is accelerated in pregnant women or during fasting. Increased ESR are caused by changes of concentration of various blood plasma proteins that are related to variation of their electric charge. However, other factors may also play a role: the dimensions and form of blood cells, changes of the lipid composition of the plasma, etc. ESR is determined by the automated erythrocyte sedimentation rate station ROLLER, model 20PN, made in Italy. Roller 20 PN station determines the erythrocyte sedimentation rate in venous and capillary blood, and provides results after only 20 seconds of operation, by measuring the erythrocyte aggregation rate. This makes it possible to overcome the limitations of and dependence on the variable factors that affect ESR estimation techniques that are based on the sedimentation phenomenon. Internal and external quality controls guarantee the accuracy, fidelity and reproducibility of patient test results. The new patented technique is based on microcapillary estimation of erythrocyte aggregation rates in pathologic conditions.
Normal values: in women aged 15-50 – (2-20) mm/h; over 50 – (2–30) mm/hr men aged 15-50 – (2-15) mm/h; over 50 – (2-20) mm/h
PREPARATION FOR BLOOD ANALYSIS
HOW DO I GET MY BLOOD TEST SAMPLE TAKEN?
- You need to complete and sign a paid service contract at the Reception or, if you have a physician's referral, present it to the receptionist.
- Pay the bill at the RCMC pay office, or through the ERIP electronic payment system.
- Have your sample taken.
Test material is accepted according to schedule: Friday through Monday, from 7:30 till 11:00, Saturday from 9:00 to 11:00 (on Saturday, tests are accepted by appointment through the Contact Center). Test results are made available to the physician and the patient at 15:00 on the same day.