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Introduction of Haematology Test

Haematology tests examine the components of blood. These tests help diagnose various blood disorders. For instance, they measure red and white blood cells. Additionally, they assess platelets and hemoglobin levels. Moreover, they detect anemia and infections. Blood tests also evaluate clotting conditions. Consequently, they aid in managing chronic diseases. Physicians often order a complete blood count. This test provides essential health information.

Furthermore, it monitors treatment effectiveness. Sometimes, haematology tests include bone marrow analysis. Thus, they can reveal bone marrow disorders. Patients need to prepare for these tests. For example, fasting might be required. Regular monitoring can detect early signs of disease. Hence, haematology tests are crucial for maintaining health. They offer valuable insights into a patient’s condition. In summary, these tests are fundamental for diagnosis and treatment.

List of Haematology Test

Normal Range of Haematology Test

Parameters  Unit Normal Range
TLC –              x10³ /μl  4-11
RBC-  x10^6/μl  M:4.5-6.0,FM: 4.0-4,5
Hb gm% M13-16, F11.5-14.5

PCV(HCT) % M:42-52; F:36-48

RBC indices:

MCV Fl  82-92

MCH PG 27-32

MCHC g/dL 32-36

Platelets x10³/μl 150-400

DLC:

Neutrophil % 40-75

Lymphocyte % 20-45

Eosinophil % 1-4

Monocyte % 2-8

Basophil % 0-1

Band Cell  %

ESR (Westergren’s method) mm/hr M: up to 15; FM: up to 20

Reticulocytes:% Adult: 0.5-2;Infant: 2-6

Bleeding Time (Ivy’s Method): min 2-7

Clotting Time (Lee and White Method): min
4-9

Prothrombin Time: Sec
10-14

INR: < 1.1

APTT: 30-40

Malaria Parasite

Microfilaria

Peripheral blood smear (PBS) Comment

Absolute Eosinophil Count

Significance: It is Absolute Eosinophil count present in Blood.

(Normal Range : 45 – 450 Cells/mm³)

Raised in following condition

1. Tropical Pulmonary Eosinophilia
2. Allergic and skin disorder
3. Worm infestation

This condition most often indicates a parasitic infection, an allergic reaction or cancer.

blood cancer cells or blast/Leukemia in peripheral blood smear (PBS)

General features

blasts are cells that have a large nucleus, immature chromatin, a prominent nucleolus, scant cytoplasm and few or no cytoplasmic granules

They are usually larger than a lymphocyte and at least the size of a monocyte.

Activated Partial Thromboplastin  Time  (APTT)

Signification: It is best screening test for coagulation disorder. This test is used in

Following condition:-

1. Monitoring Heparin therapy
2. Screening for Hemophilia
3. Detection of coagulation disorder

Normal control: 21 sec. Vary from Lab to Lab

Every LAB should establish their own control

Prolonged in:

1. Coagulation defect involving intrinsic path way factor
2. IV Heparin
3. Hemophilia

Bleeding Time (BT)

Significance: It is essential pre operative investigation to detect the bleeding status after incision. It is used in diagnosis of bleeding disorder.

Normal Range: 3-7 minutes

Increased in :

1. Thrombocytopenia- Condition in which platelets count is reduced. Bt is almost always increased if platelet count is less than 60.000/cm.
2. Drug-induced i.e. aspirin, Ibuprofen.
3. Liver disease and Uremia
4. Acute Leukemia
5. Vasculitis.

Coagulation Time (CT)

Significance: This test is one of the important preoperative investigations to detect coagulation disorder. It is not a very sensitive test.

Normal Range: 4-12 Minutes

Increased:

1. Severe deficiency of clotting factor except for factor VII and XIII
2. Hemophilia
3. Intravenous Heparin.

DLC (Differential Leucocytes Count)

Significance: It is a percentage of different white blood cells (WEB) in blood and it provides a clue to reach towards diagnosis. It is one of the most common baseline investigations utilized in day-to-day clinical practice.

Normal Range Adult                                                                     Childhood (6 months to 6 yrs)                                                                                                                                     Mean average

Polymorphs: 40-70%                                                              Polymorphs: 45% (Neutrophils)

Lymphocytes: 20-40%                                                          Lymphocytes: 48%

Eosinophils: 1-5%                                                                         Eosinophils: 0.2%

Basophils: 0-0.7%                                                                       Basophils: 05%

Increased in Leucocytes in peripheral blood may be due to an increase in the percentage of any one or two of WEB. According to the type of cell involved Leukocytosis may be described as Neutrophilia, Eosinophilia, Lymphocytosis, and Monocytosis.

Causes of Neutrophilia

1. Pyogenic infection
2. Acute inflammatory process

Causes of Eosinophilia

1. Allergic disorders
2. Worm infestation (Intestinal)
3. Skin disease
4. Tropical Pulmonary Eosinophilia (Filaria Lung infection)

Causes of Lymphocytosis:

1. Chronic infection. e.g. Tuberculosis
2. Viral fever
3. Whooping Cough

Eosinophilia Test (Blood)

Significance: The percentage of Eosinophils among total Leucocytes is done with the help of Different Leucocytes. This is most commonly advised test in clinical practice

Causes of Eosinophilia- increased in percentage of Eosinophils.

1. Allergic disorders
2. Worm infestation (Intestinal)
3. Skin disease
4. Tropical Pulmonary Eosinophilia. (Filarial lung infestation)

ESR- ERYTHROCYTE SEDIMENTATION RATE

ESR Wintrobe’s Method – It is convenient method

Normal Range: 0-10 -mm/1 hr (Male)

: 0-20 mm/ hr (Female)

ESR Western green method – It is a more Accurate Method.

Normal Range: 0-13 mm/ 1 hr (Male)

: 0-20 mm/ 1hr (Female)

Significance: It is a nonspecific test that indicates the presence and intensity of an inflammatory process. It may be used full to detect occult disease and to monitor the response of treatment in a certain disease. e.g. Tuberculosis, Rheumatoid Arthritis. SLE and  Acute Rheumatic Fever.

Increased ESR is noted in the following conditions:

1. Tuberculosis
2. Pyogenic infection
3. Acute Hepatitis
4. MI (acute)
5. Acute Rheumatic Fever
6. Pelvic inflammatory disease
7. Rheumatoid Arthritis
8. Malignancy
9. Systemic Lupus Erythematosus
10. Polymyositis

Filaria Test 

Significance: This test is done to see microfilaria in thin capillary blood especially collected during the night (8:30 pm to midnight). This is a diagnostic test for Filaria caused by Wuchereria bancrofti in India.

General Blood Picture (GBP)

Significance: This test is done to detect the morphological type of Anemia, immature or cancer cell of leucocyte series, adequacy of platelets counts, and blood parasites. It is the most common routine test of blood.

Haemoglobin

Significance: It is an iron-containing protein present in Red Blood Cells and oxygen carriers in the body. This test is done to detect the level of Anemia (Low Hemoglobin level)

Normal Range: Adult – 0-13.5 -18.0gm%

0-11.5 -16.4 gm%

: Infant 1-2 yrs.                      Mean 11.3 gm%

: Children up to 10 yrs      Mean 13.0 gm5

Decreased

1. Worm infestation (intestinal)
2. Mal nutrition
3. Blood loss
4. Pregnancy and Lactation period
5. Chronic infection

Increased

1. Polycythemia
2. Hemoconcentration due to period
3. Burn and Drug-induced

HEMOGRAM (HB. TLC, DLC, ESR, GBP)

See under individual name of test for details.

Malarial Parasite Blood Test

Significance: IT is the most common test advice in fever with chills and Rigor Commonly two methods are used to detect malaria infection.

General Blood Picture:- To see directly Malaria parasite in R B Cs

Antigen detection test: It is a rapid card test to detect antigens related to Malaria parasites.

Platelet Count

Significance: Platelets are very small non- nucleated bodies present in circulating Blood. They provide haemostasias in microcirculatory system. Its deficiency causes Bleeding and excess Thrombotic events like stroke and Heart attack.

Normal Range: 1,50,000 – 4,50,000 /mm³

If value ranges between 20,000- 50,000/cu.mm, Easy  Bruising may occur. If value reached below 20,00/cu.mm, spontaneous bleeding may occur. Value between 50,000 – 1,00,000/cu. mm causes prolonged Bleeding time and Bleeding due to major trauma.

Decreased Platelet Count is noted in the following condition.

1. Idiopathic Thrombocytopenic  purpura
2. Acute Leukemia
3. Aplastic Anemia
4. Post Measles Vaccine (Rare)
5. Post Chemotherapy

Increased Platelet Count is noted in the following condition

1. Acute Rheumatic Fever
2. Post Surgery
3. Chronic Myeloid Leukemia
4. Polycythemia
5. Post Splenectomy

Prothrombin Time (PT)

Significance: It is one of the parameters of the coagulation profile.

The test is done primary for three purpose:

1. Monitoring of oral anticoagulant therapy. e.g.  Acitrome  and it is a brand name for acenocoumarol, an anticoagulant medication used to prevent and treat harmful blood clots. It works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Acitrome is often prescribed for conditions such as deep vein thrombosis, pulmonary embolism, and to prevent stroke in individuals with atrial fibrillation or prosthetic heart valves.
2. Evaluation of Liver Function
3. Evaluation of coagulation disorder. (Especially factors involving extrinsic pathway of coagulation)

Normal Control: 14 sec. Varies from Lab to Lab

Therapeutic Normal: When a patient is on anticoagulant therapy it should be in between 1 and 1/2 to 2 times of Normal control.

Prolonged in:-

1. Extrinsic coagulation pathway factor deficiency.
2. Patients on anticoagulant therapy
3. Liver disease
4. Vitamin K deficiency
5. Inadequate V it K absorption e.g. Obstructive Jaundice
6. Chronic Pancreatitis

Reticulocyte Count

Significance: Reticulocyte is the name given to the young Red Blood cells, which are formed in Bone marrow. Few of the Reticulocytes are released in Peripheral Blood, which is counted to detect the status of Active RBC formation in Bone Marrow.

Increased Reticulocyte count:

1. Hemolytic Anemia
2. In response to Iron therapy
3. Internal hemorrhage

Decreased:

1. Aplastic Anemia
2. Cancer Chemotherapy

Total Leukocyte Count  (TLC)

Significance: Leucocytes are nucleated ells present in Blood, which provides defense against Bacterial, Viral, Parasites and Tumors. It is done of the Common Base Line investigation.

Normal Range:

Adult: 4,000-11,000/mm³

Childhood: 6,000-15,00/mm³

6 months – 6 Years: 4,500- 13,500/mm³

Increased: Any increased in number of Leucocyte above 11,00/mm³ is known as Leucicytosis.

Cause of Leucocytosis

A. Physical Leucocytosis – moderately raised Leucocytes is found in following conditions

1. New Born Baby
2. Exercise
3. Emotional Stress
4. Pregnancy

B. Pathological Leucocytosis – moderate to severely raised Leucocyte count.

1. Infection
2. Hemorrhage
3. Trauma
4. Burn
5. Blood Cancer

Decreased- Decreased in number of Leucocyte below 4,000 is known as Leukopenia. It is almost always due to Neutropenia.

1. Typhoid fever and Malarian
2. Infective hepatitis
3. Septicemia
4. Post Chemotherapy of Blood Cancer
5. Post Radio Therapy

Thalassemia Screening Test  (HB -A2)

Significance: Estimation of Hemoglobin A2 is done to detect carrier of Beta Thalassemia gene in general public. Approx. 3% of total population is carrier of this gene. Beta Thalassemia  is a genetic disorder presented with defective Hemoglobin synthesis.

Normal Range: Hb-A2- 1.5-3.5% of total Hemoglobin

Value of Hb-A2 is raised in Beta Thalassemia

Keynotes