An automated CBC with differential white blood cell count can determine 32 different hematological parameters. The complete blood count (CBC) includes: hemoglobin, hematocrit, red blood cell (RBC) count, white blood cell (WBC) count, RBC indices, platelet count, mean platelet volume (MPV), and red cell distribution width (RDW).
Hemoglobin, WBC count, RBC count, mean corpuscular volume (MCV), and platelet count are measured electronically by an automated hematology analyzer. Hematocrit, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and RDW are calculated.
Modern cell counters measure the number of RBCs within a given blood volume by electrical impedance. RBC count is usually expressed as the number of RBCs per microliter.
By itself, the RBC count is not a good indicator of anemia. However, it is used to evaluate anemia. It is used in the calculation of some some of the RBC indices.
- Hct = RBC x MCV
- MCH=Hgb/RBC
Automated cell counters incorporate a method for flagging white blood cell (WBC), red blood cell (RBC) and platelet abnormalities. The flagged abnormalities prompt a medical scientist to perform a manual peripheral smear review and differential to verify the abnormality flagged as well as allow identification of additional morphological abnormalities. RBCs are flagged if the instrument detects red cell fragments (schistocytes).
Adult reference range is 4.00-5.00 million/uL for females and 4.31 - 5.84 million/uL for males. Red cell count may decrease as much as 0.3 x 106/uL with bed rest.
Specimen requirement is one lavender top (EDTA) tube of blood.
References
Massimo D, et al, Modern hematology analyzers: beyond the simple blood cells count (with focus on the red blood cells), J Lab Precision Med, 2024;9(4): doi 10.21037/jlpm-23-32
Doig K, Zhang B, A Methodical Approach to Interpreting the Red Blood Cell Parameters of the Complete Blood Count, Clin Lab Sci, 2017;30(3):173-185.
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