Complete Blood Count (CBC) Test in Hyderabad, India
At PACE Hospitals, our advanced NABL-accredited diagnostic laboratory ensures accurate and reliable Complete Blood Count - CBC Test in Hyderabad, Telangana, India. Our experienced medical professionals analyze blood parameters with precision, providing expert insights to support personalized treatment plans for your optimal health.
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CBC Test (Complete Blood Count) Test Preparation
No special preparation is required. However, follow any specific instructions given by your doctor.
What is CBC?
CBC test full form: Complete Blood Count
The complete blood count (CBC) test, also known as a complete blood picture (CBP), is one of the most commonly performed laboratory investigations in medicine. It provides information regarding circulating blood cell size, count and quantity and can help detect a variety of disorders, including infections, anaemia, immune system diseases, and blood cancers.
The standard complete blood picture includes a measured red cell count (RBC) count, haemoglobin (Hb) level, and haematocrit (Hct), along with calculated red cell indices, a platelet count, and a white blood cell count (WBC).
Importance of Complete Blood Count
A CBC is a commonly performed routine blood test which may be ordered to detect or monitor many different health conditions, including:
- If the person is having symptoms, including weakness, fatigue, fever or other signs of an infection, weight loss, bleeding, bruising or any signs of cancer
- When a person is undergoing treatments (such as medications or radiation), that could alter the results of a blood count.
- To monitor a chronic (long-term) health problem that may change the blood count results, such as chronic kidney disease (CKD).
Benefits of CBC Test
A complete blood count (CBC) test has many uses, including:
- Diagnosis: A CBC can help identify the cause of symptoms, including weakness, fatigue, fever, pain, bruising, or bleeding. It can also help diagnose conditions including anaemia, leukaemia, infections, and blood cancers.
- Monitoring: A CBC can help monitor conditions that affect blood cell counts, such as anaemia, infection, or blood disorders. It can also help monitor how a person's condition responds to treatment, and may be used to detect side effects of some medical treatments.
- Screening: A doctor may prescribe a CBC as a screening test during routine check-ups to find health problems before there are any symptoms.
- General health: A CBC can be part of a medical exam to check general health.
CBC Test Includes
A complete blood picture (CBP) includes various counts such as red blood cells (RBCs), white blood cells (WBCs), haemoglobin, haematocrit, and platelets. This comprehensive analysis helps assess overall health and detect various medical conditions, including:
Red Blood Cell (RBC) Tests
Red blood cells
RBC stands for red blood cells, are counted in a complete blood picture to measure the amount of red blood cells present per unit volume of patient’s blood and are expressed in cells per microliter (cells/μL).
Red blood cells are examined in blood counts using parameters such as RBC, haemoglobin (Hb), haematocrit (Hct), Mean Corpuscular Volume (MCV), Red Cell Distribution Width (RDW), Mean Corpuscular Haemoglobin (MCH), and Mean Corpuscular Haemoglobin Concentration (MCHC).
Unlike Hb, RBC does not accurately measure the blood's oxygen-carrying capacity and is not directly used to diagnose anaemia. However, red cell indices are essential in evaluating anaemia.
The RBC count may appear inaccurately low in cases of red cell agglutination or when the sample is diluted due to intravenous fluid infusion.
Haemoglobin
Haemoglobin (Hb) measures the amount of haemoglobin in whole blood and is expressed in grams per decilitre (g/dL). According to the World Health Organization (WHO), normal reference ranges for haemoglobin levels are 13 to 18 g/dL in adult men and 12 to 16 g/dL in adult women who are not pregnant. During pregnancy, the lower limit is generally reduced to 10 g/dL to account for physiological plasma expansion.
A low Hb is called anaemia, while erythrocytosis is defined as a high Hb level. Hb levels are also used to assess the severity of anaemia.
Hb measurement with an automated analyser can be influenced by factors such as plasma volume. For instance, hypervolemic patients may show a haemoglobin level lower than their true level, while severely dehydrated patients may present a falsely high haemoglobin level.
Similarly, interferents in the specimen, such as lipemia (presence of a high amounts of lipids or fats in the blood), hyperbilirubinemia (build-up of bilirubin in the blood), paraproteinemia (presence of abnormal monoclonal proteins in the blood), or hyperleukocytosis, may falsely elevate the Hb levels. The causes of anaemia are broad and may result from blood loss, destruction of blood cells, or deficient production, or defective production.
Erythrocytosis (excessive red blood cells) can occur due to haemoconcentration or dehydration, or it may result from an increased production of red blood cells. This increased production can be caused by a primary myeloproliferative disorder or may occur secondary to conditions such as cyanotic heart disease, chronic respiratory issues, high altitudes, kidney problems, smoking, or tumours that secrete erythropoietin.
Haematocrit
A haematocrit test measures the percentage volume of red blood cells in the blood calculated with RBC and mean corpuscular volume (MCV): Hct = RBC x MCV/10.
Normal human blood contains red blood cells, white blood cells, platelets, and the fluid portion called plasma. In this test, the patient red blood cells are separated from the rest of their blood to be measured.
Similarly to Hb, Hct is reduced in anaemia, increased in erythrocytosis, and is influenced by changes in plasma volume.
Red Cell Indices
Red blood cell (RBC) indices are a set of measurements that are calculated as a part of a complete blood count (CBC) test. The indices measure your red blood cells' size, shape, and quality and include:
- Red Cell distribution width (RCDW)
- Mean Corpuscular Volume (MCV)
- Mean Corpuscular Haemoglobin (MCH)
- Mean corpuscular Haemoglobin Concentration (MCHC)
They are calculated using the measured Hb, Hct, and RBC and help clarify the etiology of anaemia. MCH and MCHC are also often used for quality control within laboratories.
- Red cell distribution width: A red cell distribution width (RDW) test measures the degree of variation in red cell size, known as anisocytosis (red blood cells that are of different sizes). The value is calculated as the standard deviation or the coefficient of variation of the MCV distribution curve. RCDW is expressed as a percentage, where a higher value indicates a greater variation in red cell size. RDW is useful in assessing anaemia to help further delineate etiology (underlying cause). The RDW test may also be used with other tests to help detect other conditions, such as thalassemia, an inherited condition that can cause severe anaemia.
- Mean corpuscular volume : Mean corpuscular volume (MCV) measures the average volume and size of the red blood cells present, providing essential information in the diagnostic process for anaemia. MCV is expressed in femtoliters (fL) or cubic micrometers (µm3). To calculate the MCV, the percent haematocrit is divided by the erythrocyte count (RBC count), and the result is multiplied by 10:
MCV (in fL) = (Haematocrit %)/(RBC×1012/L) × 10
Healthcare professionals advise MCV to diagnose anaemia and its type, including microcytic (red blood cells are smaller than normal—low MCV), normocytic (red blood cells are normal in size—normal MCV), or macrocytic (red blood cells are larger than normal—high MCV).
Different etiologies (different causes) are often associated with characteristic red cell morphology. However, assessing anaemia necessitates using RBC indices and peripheral smear examination rather than relying on a single parameter.
Sometimes, MCV may give misleading results (or be spuriously elevated) due to several reasons:
- Red cell agglutination, where doublet erythrocytes are automatically counted as one (Sometimes, red blood cells stick together in clumps (like little groups). When this happens, the counting machines might mistakenly count these clumps as one single cell, making the MCV look higher than it really is)
- Hyperglycaemia occurs when excess glucose causes hypertonic erythrocytes to swell, increasing RBC volume, which can falsely increase the MCV reading.
- Hypernatremia is characterized by too much salt (sodium) in the blood, which causes swelling of hypertonic erythrocytes. For the same reason, hypernatremia can lead to a higher MCV reading.
- Hyperleukocytosis is characterized by a white blood cell (WBC) count greater than 100,000/μL. Some of these larger white cells might be counted as red blood cells when the MCV is calculated, which can also cause the MCV to appear elevated.
Mean Corpuscular Haemoglobin (MCH)
Mean corpuscular haemoglobin (MCH) quantifies the amount of haemoglobin per RBC and is expressed as picograms per red cell (pg/cell). It is not measured directly; the value is calculated by dividing haemoglobin by red cell count.
MCH (pg) = Hb ÷ RBC count
MCH is dependent on cell volume and correlates closely with MCV. Conversely, the CBC also includes the mean corpuscular haemoglobin concentration (MCHC), which controls for cell volume and is helpful in evaluating anaemia.
Mean corpuscular haemoglobin concentrate (MCHC)
MCHC estimates the average haemoglobin concentration per unit volume of red blood cells, expressed as a gram per decilitre (g/dl) or percentage of Hb per cell.
In contrast to MCH, MCHC correlates the haemoglobin content with the cell volume. Like haemoglobin, the MCHC is reported in g/dL.
The value is calculated by dividing haemoglobin by haematocrit.
MCHC(g/dL) = haemoglobin ÷ haematocrit
While Mean Corpuscular Haemoglobin (MCH) quantifies the amount of haemoglobin in red blood cells, Mean Corpuscular Haemoglobin Concentration (MCHC) indicates the density of haemoglobin in each red blood cell, taking into account the Mean Corpuscular Volume (MCV).
The amount of haemoglobin in red blood cells is regulated and is typically limited to an optical density of about 34% haemoglobin per cell.
Increased MCHC can result from abnormalities in red blood cell morphology, such as spherocytosis and xerocytosis, or hemoglobinopathies.
High MCHC (Mean Corpuscular Haemoglobin Concentration) is often associated with artifacts, which can occur in the following situations:
- Lipemia (presence of excessive amounts of lipid particles in the blood), which spuriously elevates Hb and consequently MCHC
- Haemolysis (breakdown or destruction of red blood cells), where Hb is disproportionally elevated to Hct within the sample
- Red cell agglutination, which spuriously lowers the red cell concentration and elevates MCV
- Leucocytosis (high white blood cell count), which spuriously elevates MCV
- Hyperbilirubinemia (build-up of bilirubin in the blood), which spuriously lowers Hb
White Blood Cell (WBC) Tests
White blood cell count
A white blood count (leukocytes), or absolute WBC count, is part of the immune system and measures the number of white blood cells (WBCs) per blood microliter (μL).
White blood cells (WBCs) are a type of blood cell made in the human bone marrow and found in blood and lymph tissue (part of the immune system). If a person is injured or gets sick, WBCs travel through the bloodstream and tissues to where they are needed. There, they help the body fight off infections and other diseases.
A spurious leukopenia may occur due to white blood cell clumping and may occur in the setting of:
- Cryoproteinemia: an immunologic phenomenon that can cause false elevations in automated white cell and platelet counts
- Reticulocytosis, where nucleated red blood cells are counted as white blood cells
- Fibrin clumps: These are aggregates of fibrin, a protein involved in blood clotting, that form to help stop bleeding by sealing wounds.
- Platelet clumping, where aggregate platelets are counted as white blood cells
Identification of a WBC abnormality involves assessing the white cell differential to identify which white blood cell types are affected, reported either as a percentage of total WBCs or as absolute counts of each type.
The differential may be reported as a percentage of the total WBC or as an absolute count for each mature white cell type.
Neutrophil count
The neutrophil count, or absolute neutrophil count, is the number of neutrophils per microliter of blood and is expressed as a percentage of the WBC or as an absolute number. Neutrophils are a type of white blood cell that helps the body fight infection.
This count may be used to check for inflammation, leukaemia, infection, and other conditions.
The lower a person's absolute neutrophil count, the greater the risk of infection. Cancer treatment, including chemotherapy, may reduce the absolute neutrophil count. Also called ANC.
Lymphocyte count
The lymphocyte count is the number of lymphocytes per microliter of blood and is expressed as a percentage of the WBC or as an absolute number.
Clinically, the leukocyte count is one of the most economical, convenient, and frequently available markers of inflammation. However, its diagnostic and prognostic importance in cerebrovascular events remains unclear.
Monocyte count
The monocyte count is the number of monocytes per microliter of blood and is expressed as a percentage of the WBC or as an absolute number.
Monocyte cells are a type of white blood cells that fight against certain infections in body and help other white blood cells to destroy cancer cell remove damaged or dead or tissues, and regulate immunity against foreign bodies (substances).
Monocytes are produced in the bone marrow and subsequently enter the bloodstream, where they make up about 1 to 10% of circulating white blood cells. This equates to approximately 200 to 600 monocytes per microliter of blood, or 0.2 to 0.6 × 109 per litre.
After a few hours in the blood, these cells migrate to tissues including lungs, spleen, bone marrow tissue and liver), where they mature into macrophages.
Eosinophil count
The eosinophil count is the number of eosinophils per microliter of blood and is expressed as an absolute number or a percentage of the WBC.
Eosinophils (eosinophil cells) are a type of white blood cells (that play an essential role in the body's response to asthma, allergic reactions, and infection with parasites.
Eosinophils typically constitute less than 7% of circulating white blood cells, totalling 100 to 500 eosinophils per microliter of blood [0.1 to 0.5 × 109 per litre]).
These cells play a role in protective immunity against particular parasites and contribute to inflammation associated with allergic disorders. Sometimes, eosinophils cause inflammation in specific organs that results in certain symptoms.
Basophil count
The basophil count is the number of basophils present per microliter of blood and is expressed as a percentage of the WBC or as an absolute number.
Basophils (basophil cells) are a type of white blood cell (WBCs) that have a role in wound repair and immune surveillance (such as detecting (identifying early) and destroying very early cancers).
Basophils release histamine and other mediators, initiating allergic reactions.
Basophils comprise less than 3% of circulating white blood cells, ranging from 0 to 300 basophils per microliter of blood [0 to 0.3 × 109 per litre]).
Platelet count
The platelet count is the number (amount) of platelets per unit volume of blood and is expressed in cells per microliter of blood or cubic millimetre. Platelets, also known as thrombocytes, are small, colourless cell fragments in the blood that help stop bleeding and form clots.
Platelet counts can appear low due to platelet clumping when ethylenediaminetetraacetic acid (EDTA) is present in blood specimen collection tubes, leading to pseudo thrombocytopenia.
When a specimen is collected in a tube containing a different anticoagulant, such as citrate or oxalate, repeating the platelet count is recommended.
The platelet count may be spuriously elevated (falsely elevated) in bacteraemia, fungemia, or malaria, where the analyser counts microorganisms in the blood as platelets. This may also occur in the presence of red blood cell fragments, such as in haemolysis. Other platelet tests include mean platelet volume (MPV), platelet distribution width (PDW), and platelet crit (PCT). However, these are not usually included in the standard Complete Blood Count (CBC) report.
Complete Blood Count (CBC) Test Procedure
Before (Preparation)
Usually, no special preparation is necessary for a Complete blood picture test. However, if the healthcare professional orders other tests on the person's blood sample, then that person may need to fast (not eat or drink) for several hours before the test. The healthcare professional will let the person know if there are any special instructions to follow.
During
A healthcare professional (lab technician or nurse) will use a small needle (syringe) to take a blood sample from a vein into a vial or test tube. A person may feel a slight sting when the needle goes in or out. This usually takes less than five minutes.
After
Taking blood from some people may be more difficult than from others. Arteries and veins may vary in size from one person to another and from one side of the body to the other.
A person may experience slight discomfort, pain or bruising at the spot where the needle (injection) went in. However, most symptoms go away quickly.
Other problems associated with having blood drawn are slight but may include:
- Fainting or feeling lightheaded
- Excessive bleeding
- Hematoma (blood accumulating under the skin)
- Infection (which is rare)
Complete Blood Count Results Interpretation
Complete blood picture normal values and interpretation provide a comprehensive overview of an individual's blood health. These CBC results typically provide an overview of abnormalities in an individual, including:
Red blood cell count
Measures the number of red blood cells, which pick up oxygen from the blood and deliver it to tissues throughout the body.
Normal reference range:
- Male: 4.7-6.1 million/mcL
- Female: 4.2-5.4 million/mcL
- Low levels: Iron, vitamin B12, or folate deficiency; bone marrow damage; leukaemia or lymphoma; acute or chronic blood loss; red blood cell haemolysis
- High levels: Polycythaemia vera (rare blood disorder in which there is a raise in all blood cells, particularly red blood cells), dehydration, renal problems, pulmonary disease, congenital heart disease.
Haemoglobin (HgB)
Oxygen-carrying pigment in red blood cells
Normal reference range:
- Male: 13.8-18 g/dL
- Female: 12.1-16 g/dL
- Low levels: Iron, vitamin B12, or folate deficiency; bone marrow damage; leukaemia or lymphoma; acute or chronic blood loss; red blood cell haemolysis
- High levels: Polycythaemia vera (rare blood disorder in which there is a raise in all blood cells, particularly red blood cells), dehydration, renal problems, pulmonary disease, congenital heart disease.
Haematocrit (HCT)
The percentage of red blood cells
Normal reference range:
- Male: 40.7%-50.3%
- Female: 36.1%-44.3%
- Low levels: Iron, vitamin B12, or folate deficiency; bone marrow damage; leukaemia or lymphoma; acute or chronic blood loss; red blood cell haemolysis
- High levels: Polycythaemia vera Dehydration, renal problems, pulmonary disease, congenital heart disease
Red Cell Indices
Red cell distribution width (RDW)
A measurement of the variation in red blood cell size
- 11-15%
- Low levels: Generally, not a concern
- High levels: Iron deficiency, vitamin B12 or folate deficiency, recent blood loss.
Mean corpuscular volume (MCV)
Average size of red blood cells
- 80-95 fL
- Low levels: Iron deficiency
- High levels: Vitamin B12 or folate deficiency
Mean corpuscular haemoglobin (MCH)
The amount of haemoglobin per red blood cell
- 23-31 pg
- Low levels: Iron deficiency
- High levels: Vitamin B12 or folate deficiency
Mean corpuscular haemoglobin concentration (MCHC)
The average concentration of haemoglobin in a given volume of red blood cells 32-36 g/dL Iron deficiency Sickle cell disease, hereditary spherocytosis
- 32-36 g/dL
- Low levels: Iron deficiency
- High levels: Sickle cell disease, hereditary spherocytosis (inherited disease that changes the shape of and decreases the life of red blood cells).
White blood cell (WBC) count
Measures the total number of white blood cells, which defend the body against infection; there are several different types of white blood cells: lymphocytes, monocytes, neutrophils, eosinophils, and basophils.
Normal reference range:
- 4,500-10,000 cells/mcL
- Low levels: Autoimmune diseases, immunosuppression, bone marrow failure, chemotherapy, viral infections
- High levels: Infection, inflammation, leukaemia, intense exercise, stress, corticosteroids
- An abnormal number of white blood cells—either too few or too many—can indicate a medical disorder.
Leukopenia: A reduction in white blood cell count below 4,000 cells per microliter (4 × 109 per litre), often increases susceptibility to infections.
Leukocytosis: A rise in the number of white blood cells (WBCs) to more than 11,000 cells per microliter of blood (11 × 109 per litre) is often a normal response of the body to fight infections or may result from medications such as corticosteroids. However, a rise in white blood cell count can also be caused by cancers of the bone marrow, such as leukaemia, where the affected cells multiply uncontrollably.
Neutrophils, absolute (NE, abs) or percentage (NE, pct)
Measures the number or percentage of neutrophils, which are normally the most abundant circulating white blood cells and respond quickly to infection.
Normal reference range:
- 1,800-8,300 cells/mcL (abs) 45-75 (pct)
- Low levels: Immunosuppression, bone marrow failure, chemotherapy
- High levels: Infection, inflammation, leukaemia, intense exercise, stress, corticosteroids
An abnormal number of neutrophils—either too few or too many—can indicate a medical disorder.
Neutrophilia: An increase in the neutrophil count can be due to infection, trauma, physical or emotional stress, tissue necrosis, myeloproliferative disease, smoking, chronic inflammatory disease (such as rheumatoid arthritis (long-term autoimmune disease) inflammatory bowel disease, and systemic lupus erythematosus), acute gout, chronic hepatitis (long-term inflammation of liver), vasculitides, diabetic ketoacidosis, congenital conditions (such as Down syndrome and hereditary idiopathic neutrophilia), obesity, blood loss, haemolytic anaemia pregnancy, or medications.
Neutropenia: A decrease in the neutrophil count can be due to bone marrow failure (due to myeloproliferative diseases, lymphoproliferative disease, metastatic malignancy, myelodysplasia or irradiation), hereditary, megaloblastic anaemia, autoimmune disease (such as systemic lupus erythematosus and rheumatoid arthritis), hypersplenism, haemodialysis, viral infection (such as cytomegalovirus, human immunodeficiency virus, measles, rubella, infectious mononucleosis, Dengue fever), bacterial infections (such as typhoid fever or septicaemia), protozoal infections, idiopathic, or drug-induced.
Lymphocytes, absolute (LY, abs) or percentage (LY, pct)
Measures the number or percentage of lymphocytes, which are white blood cells that include B-cells, T-cells, and natural killer cells.
Normal reference range:
- 800-5,000 cells/mcL (abs) 18-45 (pct)
- Low levels: Immunosuppression, HIV-AIDS, bone marrow failure, chemotherapy
- High levels: Viral infections, leukaemia, lymphoma
An abnormal number of lymphocytes—either too few or too many—can indicate a medical disorder.
Lymphocytosis: An increase in the lymphocyte count may be due to viral infection, tuberculosis (TB), toxoplasmosis, pertussis, brucellosis, hyposplenism, or lymphoproliferative disease.
Lymphocytopenia: A decrease in the lymphocyte count, may be due to viral or bacterial infection, autoimmune disease (such as rheumatoid arthritis, systemic lupus erythematosus, Sjogren syndrome, and inflammatory bowel disease (IBD)), malignancy, lymphoproliferative disease, myeloproliferative disease, primary immunodeficiency diseases or medications.
Monocytes, absolute (MO, abs) or percentage (MO, pct)
Measures the number or percentage of monocytes, which are white blood cells that move out of the circulating blood and into the tissues, where they mature into macrophages
Normal reference range:
- 400-1,000 cells/mcL (abs) 1-10 (pct)
An abnormal number of monocytes—either too few or too many—can indicate a medical disorder.
- Low levels: Immunosuppression, bone marrow failure, chemotherapy
- High levels: Chronic infections, autoimmune diseases, leukaemia
Monocytosis: An increase in the monocyte count, can be caused by viral or parasitic infection, tuberculosis, listeriosis ( foodborne illness caused by the bacteria), brucellosis (bacterial disease), endocarditis ( inflammation of the heart's inner lining), granulomatous disease, autoimmune disease (such as inflammatory bowel disease, systemic lupus erythematosus(chronic disease that causes inflammation in connective tissues) and rheumatoid arthritis), malignancy, myeloproliferative disease (rare, potentially life-threatening blood cancers), lymphoproliferative disease (group of diseases that cause an uncontrolled production of lymphocytes), haemolytic anaemia (premature destruction of erythrocytes), cigarette smoking, or medications.
Monocytopenia: A decrease in the monocyte count is observed in infection, autoimmune disease (such as systemic lupus erythematosus), aplastic anaemia, lymphoproliferative disease (particularly hairy cell leukaemia), or induced by medications.
Eosinophils, absolute (EOS, abs) or percentage (EOS, pct)
Measures the number or percentage of eosinophils, which combat parasitic infections and are involved in asthma or allergy responses
Normal reference range:
- 0-800 cells/mcL (abs) 0-7 (pct)
- Low levels: Generally, not a concern
- High levels: Parasitic infections
An abnormal number of Eosinophils —either too few or too many —can indicate a medical disorder.
Eosinophilia: An increase in the eosinophil count may be due to malignancy, lymphoproliferative disease, myeloproliferative disease, parasitic infection (such as Toxocara sp, Ascaris, Strongyloides stercoralis, Filariasis, Schistosomiasis, Trichinella, Cysticercosis or Echinococcus), hypersensitivity reactions, connective tissue disease (such as polyarteritis nodosa (inflammatory blood vessel disease), rheumatoid arthritis), atopic disease (genetic predisposition to develop an allergic reaction), skin disorders (such as psoriasis or scabies), idiopathic hypereosinophilic syndrome (characterized by a persistently elevated eosinophil count ) Loeffler syndrome (eosinophilic pulmonary disease), pulmonary infiltration with eosinophilia, vasculitides (group of rare conditions that cause inflammation and damage blood vessels- especially eosinophilic granulomatosis with polyangiitis (rare disorder in which blood vessels become inflamed)) or induced by medications.
Eosinopenia: A decrease in the eosinophil count is seen in conditions such as inflammation, acute stress, or drug-induced (most notably glucocorticoids).
Basophils, absolute (BAS, abs) or percentage (BAS, pct)
Measures the number or percentage of basophils, which are involved in allergy responses.
Normal reference range:
- 0-100 cells/mcL (abs) 0-0.5 (pct)
- Low levels: Generally, not a concern
- High levels: Active allergic response
An abnormal number of Basophils —either too few or too many —can indicate a medical disorder.
Basophilia: An increase in the basophil count may be due to malignancy (cancer), lymphoproliferative disease, endocrinopathy (a disease that occurs when an endocrine gland malfunctions, resulting in a hormone problem), myeloproliferative disease, viral infection, tuberculosis, chronic inflammatory disease (such as inflammatory bowel disease or rheumatoid arthritis), allergy, anaphylaxis or drug-induced.
Basopenia: A decrease in the basophil count may be due to acute hyperthyroidism (overactive thyroid), infection, ovulation, or medications.
Platelet count (PLT)
Measures the number of platelets, which are important for blood clotting
Normal reference range:
- 150-400 thousand/mcL or 150,000 to 400,000/μL or mm3
- Low levels: Bone marrow failure, chemotherapy, viral infections, lupus, pernicious anaemia (due to vitamin B12 deficiency), leukaemia or lymphoma, sequestration in the spleen, certain medications
- High levels: Leukaemia, myeloproliferative disorders (which cause blood cells to grow abnormally in bone marrow), inflammatory conditions.
An abnormal number of platelet count—either too few or too many —can indicate a medical disorder.
Thrombocytopenia: A decrease in the platelet count can be due to diminished production, raised splenic sequestration (increased trapping of blood cells in the spleen), often leading to reduced blood cell counts in circulation or increased peripheral utilization (enhanced consumption of nutrients or oxygen by tissues in the body, often in response to increased metabolic demand) and is defined by a platelet count of less than 150,000/μL or mm3.
However, major bleeding is uncommon unless the platelet count drops below 50,000/μL or mm³.
The risk of unexpected major bleeding significantly increases below 20,000/μL, and the risk of spontaneous cerebral bleeding dramatically rises at counts below 10,000/μL.
Thrombocytosis: An increase in the platelet count is defined as a platelet count above 450,000/μL or mm3; however, it is rarely symptomatic unless the platelet count is above 1,000,000/μL or mm3. This may be due to primary myeloproliferative disorders, secondary to bone marrow stimulation, or decreased sequestration post-splenectomy.
The platelet count may be falsely elevated in bacteraemia (the presence of bacteria in the blood), fungemia (the presence of fungi or yeast in the blood), or malaria, where the analyser counts microorganisms in the blood as platelets. This may also occur in the presence of red blood cell fragments, such as in haemolysis. Other platelet tests include mean platelet volume (MPV), platelet distribution width (PDW), and platelet crit (PCT); however, these are not typically reported with the standard CBC.
CBC Test Results
The complete blood count test results include measurements of red blood cells, white blood cells, haemoglobin, haematocrit, and platelets, offering insights into anaemia, infection, and other conditions, including:
| Substance | Reference range | What a Low Number May Mean | What a High Number May Mean |
|---|---|---|---|
| RBC: Red blood cell counts the total number of white blood cells, which defend the body | Male: 4.7-6.1 million/mcL Female: 4.2-5.4 million/mcL | Low count indicates a haemorrhage, anaemia or Iron, vitamin B12, or folate deficiency; bone marrow damage; leukaemia or lymphoma; acute or chronic blood loss; red blood cell haemolysis | High count indicates clotting as in atherosclerosis |
| Haemoglobin (HgB): Oxygen-carrying pigment in red blood cells | Male: 13.8-18 g/dL Female: 12.1-16 g/dL | Iron, vitamin B12, or folate deficiency; bone marrow damage; leukaemia or lymphoma; acute or chronic blood loss; red blood cell haemolysis | Polycythaemia vera (rare blood disorder in which there is a raise in all blood cells, particularly red blood cells), dehydration, renal problems, pulmonary disease, congenital heart disease. |
| Haematocrit (HCT): The percentage of red blood cells | Male: 40.7%-50.3% Female: 36.1%-44.3% | Iron, vitamin B12, or folate deficiency; bone marrow damage; leukaemia or lymphoma; acute or chronic blood loss; red blood cell haemolysis | Polycythaemia vera Dehydration, renal problems, pulmonary disease, congenital heart disease |
| Red cell distribution width (RDW): A measurement of the variation in red blood cell size | 11-15% | Generally, not a concern | Iron deficiency, vitamin B12 or folate deficiency, recent blood loss |
| Mean corpuscular volume (MCV): Average size of red blood cells | 80-95 fL | Iron deficiency | Vitamin B12 or folate deficiency |
| Mean corpuscular haemoglobin (MCH): The amount of haemoglobin per red blood cell | 23-31 pg | Iron deficiency | Vitamin B12 or folate deficiency |
| Mean corpuscular haemoglobin concentration (MCHC): The average concentration of haemoglobin in a given volume of red blood cells 32-36 g/dL Iron deficiency Sickle cell disease, hereditary spherocytosis | 32-36 g/dL | Iron deficiency | Sickle cell disease, hereditary spherocytosis (inherited disease that changes the shape of and decreases the life of red blood cells). |
| WBC: Measures the total number of white blood cells, which defend the body against infection; there are several different types of white blood cells: lymphocytes, monocytes, neutrophils, eosinophils, and basophils | 4,500-10,000 cells/mcL | Autoimmune diseases, immunosuppression, bone marrow failure, chemotherapy, viral infections | Infection, inflammation, leukaemia, intense exercise, stress, corticosteroids |
| Lymphocytes, absolute (LY, abs) or percentage (LY, pct): Measures the number or percentage of lymphocytes, which are white blood cells that include B-cells, T-cells, and natural killer cells | 800-5,000 cells/mcL (abs) 18-45 (pct) | Immunosuppression, HIV-AIDS, bone marrow failure, chemotherapy | Viral infections, leukaemia, lymphoma |
| Monocytes, absolute (MO, abs) or percentage (MO, pct): Measures the number or percentage of monocytes, which are white blood cells that move out of the circulating blood and into the tissues, where they mature into macrophages | 400-1,000 cells/mcL (abs) 1-10 (pct) | Immunosuppression, bone marrow failure, chemotherapy | Chronic infections, autoimmune diseases, leukaemia |
| Neutrophils, absolute (NE, abs) or percentage (NE, pct): Measures the number or percentage of neutrophils, which are normally the most abundant circulating white blood cells and respond quickly to infection | 1,800-8,300 cells/mcL (abs) 45-75 (pct) | Immunosuppression, bone marrow failure, chemotherapy | Infection, inflammation, leukaemia, intense exercise, stress, corticosteroids |
| Eosinophils, absolute (EOS, abs) or percentage (EOS, pct): Measures the number or percentage of eosinophils, which combat parasitic infections and are involved in asthma or allergy responses | 0-800 cells/mcL (abs) 0-7 (pct) | Generally, not a concern | Parasitic infections |
| Basophils, absolute (BAS, abs) or percentage (BAS, pct): Measures the number or percentage of basophils, which are involved in allergy responses | 0-800 cells/mcL (abs) 0-7 (pct) | Generally, not a concern | Active allergic response |
| Platelet count (PLT): Measures the number of platelets, which are important for blood clotting | 150-400 thousand/mcL or 150,000 to 400,000/μL or mm3 | Bone marrow failure, chemotherapy, viral infections, lupus, pernicious anaemia (due to vitamin B12 deficiency), leukaemia or lymphoma, sequestration in the spleen, certain medications | Leukaemia, myeloproliferative disorders (which cause blood cells to grow abnormally in bone marrow), inflammatory conditions |
However, diet, physical activity level, a menstrual period in females, medicines, not drinking adequate water, and other factors may affect the results of CBC.
Complete Blood Picture Report Normal Values in Pregnant Women
Understanding laboratory investigations depends on reference intervals. Variability exists among laboratories due to testing methods, assay types, and population factors. The following are some of the reference values for complete blood count during pregnancy.
| Assay | Baseline | First trimester | Second trimester | Third trimester |
|---|---|---|---|---|
| Haemoglobin (Hb) (g/dL) | 12–16 | 11.5–14 | 10–15 | 9.5–15 |
| Haematocrit (%) | 35–44 | 31–41 | 30–39 | 28–40 |
| White blood cells (WBC) (×109/L) | 4–10 | 6–16 | 6–16 | 6–16 |
| Platelets (×109/L) | 150–400 thousand/mcL or 150,000 to 400,000/μL or mm3 | 170–390 | 150–400 | 145–400 |
| MCV, fL | 80-95 | 88-101 | 89-104 | 90-104 |
| MCH, pg | 23-31 | >30.1 | >29.9 | >30.2 |
| MCHC, g/dL | 32-36 | >32.6 | >31.7 | >32.2 |
Lymphocyte counts decrease during the first and second trimesters, then rise in the third trimester. Monocyte levels increase in the first trimester and then decline as pregnancy progresses. Eosinophil and basophil counts remain unchanged throughout pregnancy.
These reference intervals are provided only to illustrate trends in changes during pregnancy. They are not used as reference intervals for patient diagnosis and management. Clinicians refer to the specific reference intervals established by the laboratory that conducted the testing.
Frequently Asked Questions (FAQs) on Complete Blood Count (CBC)
Can complete blood count detect pregnancy?
A complete blood count (CBC) cannot directly detect pregnancy. However, it can reveal changes in blood components that may indicate pregnancy-related conditions. To confirm pregnancy, a specific test called human chorionic gonadotropin (hCG) test measures the levels of human chorionic gonadotropin (hCG).
Does complete blood count test detect HIV infection?
A complete blood count (CBC) or complete blood picture (CBP) does not directly detect HIV infection. While a complete blood count (CBC) does not directly detect HIV, it can show certain indicators such as low white blood cell counts. These indicators may suggest an underlying infection, but to confirm HIV, specific tests that detect the virus or antibodies are necessary.
What is the use of CBC blood test?
A CBC can be used to monitor and diagnose medical conditions, check the health of the immune system and detect infections, anaemia, and diseases of the immune system. It monitors how certain medications, medical conditions, or treatments such as chemotherapy are affecting the patient's blood.
How accurate is the complete blood count (CBC) test?
Complete blood count (CBC) tests are generally accurate, but they aren't always definitive and can produce unreliable results due to the influence of some factors such as sample handling, patient hydration, and underlying health issues.
Does complete blood picture include HSG?
No, a complete blood picture (CBC) does not include a hysterosalpingogram (HSG). A CBC is a routine blood test that measures the amount and size of red and white blood cells, haemoglobin, haematocrit, and platelets. It can help diagnose and monitor conditions such as infections, blood diseases, immune system disorders, or other medical conditions. An HSG is an X-ray test procedure performed to examine the uterus and fallopian tubes.
Is a complete blood count (CBC) a blood test?
Yes, a complete blood count (CBC) is a routine blood test that measures the quantity and size of different parts of the blood, including haemoglobin (Hb), white blood cells (WBC), red blood cells (RBC), haematocrit, and platelets. It can help detect (diagnose) and monitor many conditions, including anaemia, infections, etc.
How to detect cancer from complete blood count?
A CBC can detect abnormal levels of white blood cells, red blood cells, or platelets, which could indicate blood cancer. However, abnormal results could also be due to other conditions, such as anaemia, heart disease, or an autoimmune disorder. However, to detect cancer, these findings alone are inconclusive for detecting cancer, and further investigation is required through specific additional tests and imaging.
Does a complete blood count show electrolytes?
A complete blood count (CBC) does not measure electrolytes; it focuses on blood components like red blood cells, white blood cells, and platelets. Electrolyte levels can be evaluated only by performing certain specific tests, such as BMP (Basic Metabolic Panel) or CMP (Comprehensive Metabolic Panel), which include estimating certain blood constituents such as sodium, potassium, and chloride.
Does the CBC complete blood count blood test detect any illnesses?
A complete blood count (CBC) can help detect various illnesses by revealing abnormalities in blood components. For instance, it can indicate infections, anaemia, and certain blood disorders. While a CBC provides valuable insights, it is not definitive for specific diseases and often requires further testing for accurate diagnosis.
How many vials of blood are needed for CBC?
A complete blood count, CBC, requires one to two vials of blood (blood for complete blood picture). The minimum number of vials may vary according to the demand of the lab, and tests are carried out simultaneously. Each vial is supposed to contain a predetermined amount of blood to ensure proper analysis.
When is a complete blood count test ordered?
A complete blood count (CBC) test is typically ordered to evaluate overall health and detect various medical conditions, such as anaemia, infection, and blood disorders. It may be requested during routine check-ups, before surgeries, or when a patient presents with symptoms like fatigue, weakness, or fever. Additionally, it can be used to monitor the effects of treatments or diseases.
