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Complete Blood Count (CBC)

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Test Overview
A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood,
especially red blood cells , white blood cells , and platelets . A CBC helps your doctor check any symptoms, such as
weakness, fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia ,
infection, and many other disorders.
A CBC test usually includes:
White blood cell (WBC, leukocyte) count. White blood cells protect the body against infection. If an infection
develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are
bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells
rises very quickly. The number of white blood cells is sometimes used to find an infection or to see how the body is
dealing with cancer treatment.
White blood cell types (WBC differential). The major types of white blood cells are neutrophils , lymphocytes,
monocytes, eosinophils, and basophils. Immature neutrophils, called band neutrophils, are also part of this test. Each
type of cell plays a different role in protecting the body. The numbers of each one of these types of white blood cells
give important information about the immune system . Too many or too few of the different types of white blood
cells can help find an infection, anallergic or toxic reaction to medicines or chemicals, and many conditions, such
as leukemia .
Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry
carbon dioxide back to the lungs so it can be exhaled. If the RBC count is low (anemia), the body may not be getting
the oxygen it needs. If the count is too high (a condition called polycythemia), there is a chance that the red blood
cells will clump together and block tiny blood vessels (capillaries). This also makes it hard for your red blood cells
to carry oxygen.
Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells
take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a
hematocrit of 38 means that 38% of the blood's volume is made of red blood cells. Hematocrit
and hemoglobin values are the two major tests that show if anemia or polycythemia is present.
Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell
its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's
ability to carry oxygen throughout the body.
Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular
hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine,
and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The
MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of
hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell
distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes.
Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell. They are important in
blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the
bleeding. If there are too few platelets, uncontrolled bleeding may be a problem. If there are too many platelets,
there is a chance of a blood clot forming in a blood vessel. Also, platelets may be involved in hardening of the
arteries ( atherosclerosis ).
Mean platelet volume (MPV). Mean platelet volume measures the average amount (volume) of platelets. Mean
platelet volume is used along with platelet count to diagnose some diseases. If the platelet count is normal, the mean
platelet volume can still be too high or too low.
Your doctor may order a blood smear test to be done at the same time as a CBC but it is not part of the regular CBC test.
In this test, a drop of blood is spread (smeared) on a slide and stained with a special dye. The slide is looked at under a
microscope. The number, size, and shape of red blood cells, white blood cells, and platelets are recorded. Blood cells with
different shapes or sizes can help diagnose many blood diseases, such as leukemia,malaria , or sickle cell disease .
Why It Is Done
A complete blood count may be done to:
Find the cause of symptoms such as fatigue, weakness, fever, bruising, or weight loss.
Check for anemia.
See how much blood has been lost if there is bleeding.
Diagnose polycythemia .
Check for an infection.
Diagnose diseases of the blood, such as leukemia.
Check how the body is dealing with some types of drug or radiation treatment.
Check how abnormal bleeding is affecting the blood cells and counts.
Screen for high and low values before a surgery.
See if there are too many or too few of certain types of cells. This may help find other conditions, such as too many
eosinophils may mean an allergy or asthma is present.
A complete blood count may be done as part of a regular physical examination. A blood count can give valuable
information about the general state of your health.
Results
A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood,
especially red blood cells , white blood cells , and platelets . A CBC helps your doctor check any symptoms, such as
weakness, fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia ,
infection, and many other disorders.
Normal
The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and your lab
may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor
will evaluate your results based on your health and other factors. This means that a value that falls outside the normal
values listed here may still be normal for you or your lab.
Normal values for the complete blood count (CBC) tests depend on age, sex, how high above sea level you live, and the
type of blood sample. Your doctor may use all the CBC values to check for a condition. For example, the red blood cell
(RBC) count, hemoglobin (Hgb), and hematocrit (HCT) are the most important values needed to tell whether a person has
anemia, but the red blood cell indices and the blood smear also help with the diagnosis and may show a possible cause for
the anemia.
To see if the white blood cell (WBC, leukocyte) count is good and how the cells look on the smear, your doctor will look
at both the number (WBC count) and the WBC differential. To see whether there are too many or too few of a certain type
of cell, your doctor will look at the total count and the percentage of that particular cell. There are normal values for the
total number of each type of white cell.
Pregnancy can change these blood values. Your doctor will talk with you about normal values during each trimester of
your pregnancy.
White blood cell (WBC, leukocyte) count footnote1

Men and nonpregnant 5,000-10,000 WBCs per cubic millimeter (mm ) or 3

5.0-10.0 x 10 WBCs per liter (L)


9

women:

White blood cell types (WBC differential) footnote1

Neutrophils: 50%-62%

Band neutrophils: 3%-6%

Lymphocytes: 25%-40%
Monocytes: 3%-7%

Eosinophils: 0%-3%

Basophils: 0%-1%

Red blood cell (RBC) count footnote1

Men: 4.5-5.5 million RBCs per microliter (mcL) or 4.5-5.5 x 1012/liter


(L)

Women: 4.0-5.0 million RBCs per mcL or 4.0-5.0 x 10 /L 12

Children: 3.8-6.0 million RBCs per mcL or 3.8-6.0 x 10 /L 12

Newborn: 4.1-6.1 million RBCs per mcL or 4.1-6.1 x 10 /L 12

Hematocrit (HCT) footnote1

Men: 42%-52% or 0.42-0.52 volume fraction

Women: 36%-48% or 0.36-0.48 volume fraction

Children: 29%-59% or 0.29-0.59 volume fraction

Newborns: 44%-64% or 0.44-0.64 volume fraction

Hemoglobin (Hgb) footnote1

Men: 14-17.4 grams per deciliter (g/dL) or 140-174 grams per liter (g/L)

Women: 12-16 g/dL or 120-160 g/L

Children: 9.5-20.5 g/dL or 95-205 g/L

Newborn: 14.5-24.5 g/dL or 145-245 g/L

In general, a normal hemoglobin level is about one-third the value of the hematocrit.
Red blood cell indices footnote1
Mean corpuscular volume (MCV)-Adults: 84-96 femtoliters (fL)

Mean corpuscular hemoglobin (MCH)- 28-34 picograms (pg)per


cell
Adults:

Mean corpuscular hemoglobin 32-36 grams per deciliter


concentration (MCHC)-Adults: (g/dL)

Red cell distribution width (RDW) footnote1

Normal: 11.5%-14.5%

Platelet (thrombocyte) count footnote1

Adults: 140,000-400,000 platelets per mm3 or 140-400 x 109/L

Children: 150,000-450,000 platelets per mm 3 or 150-450 x 109/L

Mean platelet volume (MPV) footnote1

Adults: 7.4-10.4 mcm3 or 7.4-10.4 fL

Children: 7.4-10.4 mcm3 or 7.4-10.4 fL

Blood smear

Normal: Blood cells are normal in shape, size, color, and number.

High values
Red blood cell (RBC)
Conditions that cause high RBC values include smoking, exposure to carbon monoxide, long-term lung disease,
kidney disease, some cancers, certain forms of heart disease, alcoholism, liver disease, a rare disorder of the bone
marrow ( polycythemia vera ), or a rare disorder of hemoglobin that binds oxygen tightly.
Conditions that affect the body's water content can also cause high RBC values. These conditions
include dehydration , diarrhea or vomiting, excessive sweating, and the use of diuretics . The lack of fluid in the
body makes the RBC volume look high. This is sometimes called spurious polycythemia.
White blood cell (WBC, leukocyte)
Conditions that cause high WBC values include infection, inflammation, damage to body tissues (such as a heart
attack ), severe physical or emotional stress (such as a fever, injury, or surgery), kidney failure,lupus , tuberculosis
(TB) , rheumatoid arthritis , malnutrition, leukemia , and diseases such as cancer.
The use of corticosteroids , underactive adrenal glands , thyroid glandproblems, certain medicines, or removal of
the spleen can also cause high WBC values.
Platelets
High platelet values may be seen with bleeding, iron deficiency, some diseases like cancer, or problems with the
bone marrow.
Low values
Red blood cell (RBC)
Anemia lowers RBC values. Anemia can be caused by heavy menstrual bleeding, stomach ulcers , colon
cancer , inflammatory bowel disease , some tumors, Addison's disease , thalassemia , lead poisoning , sickle cell
disease , or reactions to some chemicals and medicines. A low RBC value may also be seen if the spleen has been
taken out.
A lack of folic acid or vitamin B12 can also cause anemia, such aspernicious anemia , which is a problem with
absorbing vitamin B12.
The RBC indices value and a blood smear may help find the cause of anemia.
White blood cell (WBC, leukocyte)
Conditions that can lower WBC values include chemotherapy and reactions to other medicines, aplastic anemia ,
viral infections, malaria , alcoholism, AIDS , lupus , and Cushing's syndrome .
A large spleen can lower the WBC count.
Platelets
Low platelet values can occur in pregnancy or idiopathic thrombocytopenic purpura (ITP) and other conditions that
affect how platelets are made or that destroy platelets.
A large spleen can lower the platelet count.
Results
A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood,
especially red blood cells , white blood cells , and platelets . A CBC helps your doctor check any symptoms, such as
weakness, fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia ,
infection, and many other disorders.
Normal
The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and your lab
may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor
will evaluate your results based on your health and other factors. This means that a value that falls outside the normal
values listed here may still be normal for you or your lab.
Normal values for the complete blood count (CBC) tests depend on age, sex, how high above sea level you live, and the
type of blood sample. Your doctor may use all the CBC values to check for a condition. For example, the red blood cell
(RBC) count, hemoglobin (Hgb), and hematocrit (HCT) are the most important values needed to tell whether a person has
anemia, but the red blood cell indices and the blood smear also help with the diagnosis and may show a possible cause for
the anemia.
To see if the white blood cell (WBC, leukocyte) count is good and how the cells look on the smear, your doctor will look
at both the number (WBC count) and the WBC differential. To see whether there are too many or too few of a certain type
of cell, your doctor will look at the total count and the percentage of that particular cell. There are normal values for the
total number of each type of white cell.
Pregnancy can change these blood values. Your doctor will talk with you about normal values during each trimester of
your pregnancy.
White blood cell (WBC, leukocyte) count footnote1

Men and nonpregnant 5,000-10,000 WBCs per cubic millimeter (mm ) or


3

5.0-10.0 x 109 WBCs per liter (L)


women:

White blood cell types (WBC differential) footnote1

Neutrophils: 50%-62%

Band neutrophils: 3%-6%

Lymphocytes: 25%-40%

Monocytes: 3%-7%

Eosinophils: 0%-3%

Basophils: 0%-1%

Red blood cell (RBC) count footnote1

Men: 4.5-5.5 million RBCs per microliter (mcL) or 4.5-5.5 x 1012/liter


(L)

Women: 4.0-5.0 million RBCs per mcL or 4.0-5.0 x 10 /L 12

Children: 3.8-6.0 million RBCs per mcL or 3.8-6.0 x 10 /L 12

Newborn: 4.1-6.1 million RBCs per mcL or 4.1-6.1 x 10 /L 12

Hematocrit (HCT) footnote1

Men: 42%-52% or 0.42-0.52 volume fraction

Women: 36%-48% or 0.36-0.48 volume fraction

Children: 29%-59% or 0.29-0.59 volume fraction

Newborns: 44%-64% or 0.44-0.64 volume fraction

Hemoglobin (Hgb) footnote1

Men: 14-17.4 grams per deciliter (g/dL) or 140-174 grams per liter (g/L)
Women: 12-16 g/dL or 120-160 g/L

Children: 9.5-20.5 g/dL or 95-205 g/L

Newborn: 14.5-24.5 g/dL or 145-245 g/L

In general, a normal hemoglobin level is about one-third the value of the hematocrit.
Red blood cell indices footnote1

Mean corpuscular volume (MCV)-Adults: 84-96 femtoliters (fL)

Mean corpuscular hemoglobin (MCH)- 28-34 picograms (pg)per


cell
Adults:

Mean corpuscular hemoglobin 32-36 grams per deciliter


concentration (MCHC)-Adults: (g/dL)

Red cell distribution width (RDW) footnote1

Normal: 11.5%-14.5%

Platelet (thrombocyte) count footnote1

Adults: 140,000-400,000 platelets per mm3 or 140-400 x 109/L

Children: 150,000-450,000 platelets per mm 3 or 150-450 x 109/L

Mean platelet volume (MPV) footnote1

Adults: 7.4-10.4 mcm3 or 7.4-10.4 fL

Children: 7.4-10.4 mcm3 or 7.4-10.4 fL

Blood smear

Normal: Blood cells are normal in shape, size, color, and number.
High values
Red blood cell (RBC)
Conditions that cause high RBC values include smoking, exposure to carbon monoxide, long-term lung disease,
kidney disease, some cancers, certain forms of heart disease, alcoholism, liver disease, a rare disorder of the bone
marrow ( polycythemia vera ), or a rare disorder of hemoglobin that binds oxygen tightly.
Conditions that affect the body's water content can also cause high RBC values. These conditions
include dehydration , diarrhea or vomiting, excessive sweating, and the use of diuretics . The lack of fluid in the
body makes the RBC volume look high. This is sometimes called spurious polycythemia.
White blood cell (WBC, leukocyte)
Conditions that cause high WBC values include infection, inflammation, damage to body tissues (such as a heart
attack ), severe physical or emotional stress (such as a fever, injury, or surgery), kidney failure,lupus , tuberculosis
(TB) , rheumatoid arthritis , malnutrition, leukemia , and diseases such as cancer.
The use of corticosteroids , underactive adrenal glands , thyroid glandproblems, certain medicines, or removal of
the spleen can also cause high WBC values.
Platelets
High platelet values may be seen with bleeding, iron deficiency, some diseases like cancer, or problems with the
bone marrow.
Low values
Red blood cell (RBC)
Anemia lowers RBC values. Anemia can be caused by heavy menstrual bleeding, stomach ulcers , colon
cancer , inflammatory bowel disease , some tumors, Addison's disease , thalassemia , lead poisoning , sickle cell
disease , or reactions to some chemicals and medicines. A low RBC value may also be seen if the spleen has been
taken out.
A lack of folic acid or vitamin B12 can also cause anemia, such aspernicious anemia , which is a problem with
absorbing vitamin B12.
The RBC indices value and a blood smear may help find the cause of anemia.
White blood cell (WBC, leukocyte)
Conditions that can lower WBC values include chemotherapy and reactions to other medicines, aplastic anemia ,
viral infections, malaria , alcoholism, AIDS , lupus , and Cushing's syndrome .
A large spleen can lower the WBC count.
Platelets
Low platelet values can occur in pregnancy or idiopathic thrombocytopenic purpura (ITP) and other conditions that
affect how platelets are made or that destroy platelets.
A large spleen can lower the platelet count.