INTERPRETASI PROFIL

HEMATOLOGI PADA PASIEN ANAK

UNTUK PENEGAKKAN DIAGNOSIS

Sumayya Nuri Fuadana Aulia Ul Haque, dr.

Pembimbing:
Nevin Chandra J., dr., Sp.A
 JENIS-JENIS PEMERIKSAAN

• Hemoglobin • Rhesus • G6PD

• Hematokrit • Bleeding Time • Hb Elektroforesis
• Leukosit • Clotting Time • Agregasi Trombosit
• Eritrosit • MCV, MCH, MCHC • TIBC
• Trombosit • PT/APTT • Retikulosit
• LED • Retraksi Bekuan • Rumple Leed
• Golongan darah • SADT
Hemoglobin

Hemoglobin (Hb), the main component of the red blood cell

(RBC), is a conjugated protein that serves as the vehicle for
the transportation of oxygen (O2) and carbon dioxide (CO2).
Hematokrit

Ratio of the volume of erythrocytes to that of the whole

blood.

• Adult males are 0.41–0.51, and for females, 0.36–0.45

• Below the reference interval for age and sex indicates anemia, and a higher
value, polycythemia.
• The Hct reflects the concentration of red cells—not the total red cell mass.
• The Hct is low in hydremia of pregnancy, but the total number of circulating red
cells is not reduced.
• The Hct may be normal or even high in shock accompanied by
hemoconcentration, although the total red cell mass may be decreased
considerably owing to blood loss.
• The Hct is unreliable as an estimate of anemia immediately after loss of blood or
immediately following transfusions.
Retikulosit
Reticulocytes are immature nonnucleated red cells that
contain ribonucleic acid (RNA) and continue to synthesize Hb
after loss of the nucleus.

• Normal adults have a reticulocyte count of 0.5%–1.5%, or 24–84 ×

109/L.
• In newborn infants, the percentage is 2.5%–6.5%; this falls to the adult
range by the end of the second week of life.

Because reticulocytes are immature red cells that lose their

RNA a day or so after reaching the blood from the marrow, a
reticulocyte count provides an estimate of the rate of red cell
production.
Eritrosit
Circular, homogeneous disks of nearly uniform size, ranging
from 6–8 μm in diameter, as small as 5.5 μm and as large as
9.5 μm. The center of each is somewhat paler than the
periphery.

Erythrocytes appear as circular, homogeneous disks of nearly uniform size, ranging

from 6–8 μm in diameter, with central pallor not exceeding more than one third of
the cell.
MCV, MCH, MCHC
Wintrobe introduced calculations for determining the size, content,
and Hb concentration of red cells; these erythrocyte indices have
been useful in the morphologic characterization of anemias.

MCV
The MCV, the average volume of red cells, is calculated from the Hct and
the red cell count.
MCH
The MCH is the content (weight) of Hb of the average red cell; it is
calculated from the Hb concentration and the red cell count.
MCHC
The mean cell hemoglobin concentration (MCHC) is the average
concentration of Hb in a given volume of packed red cells.
The depth of staining furnishes a rough guide to the amount of Hb in red
cells, and the terms normochromic, hypochromic, and hyperchromic are
used to describe this feature of red cells

Normochromic = normal intensity of staining

When the amount of Hb is diminished, the central pale area becomes

larger and paler. This is known as hypochromia. The MCH and MCHC are
usually decreased

In megaloblastic anemia, because the red cells are larger and hence thicker, many
stain deeply and have less central pallor. These
cells are hyperchromic because they have an increased MCH, but the
MCHC is normal.
The presence of hypochromic cells and
In hereditary spherocytosis the cells normochromic cells in the same film is
called anisochromia or, sometimes, a
are also hyperchromic; although the dimorphic anemia. This is characteristic
MCH is normal, the MCHC is usually of sideroblastic anemias but also is found
increased because of a reduced some weeks after iron therapy for iron
surface/volume ratio. deficiency anemia, or in a hypochromic
anemia after transfusion with normal cells.
Leukosit

Differential Counts
NEUTROFIL
Neutrophils average 12 mm in diameter;
they are smaller than monocytes
and eosinophils and slightly larger than
basophils.
Neutrophilia or neutrophilic leukocytosis is
an increase in the
absolute count, and neutropenia is a
decrease.
 EUSINOFIL
Eosinophils average 13 μm in diameter.

Eosinophils
average 3% of the leukocytes in adults, and the upper reference value
is 0.6 × 109/L when calculated from the differential count. If allergic
individuals
are excluded, the upper limit is probably 0.35 × 109/L or 350/μL.
The lower reference value is probably 40/μL; a decrease in
eosinophils
(eosinopenia)
 BASOFIl
In general, basophils resemble neutrophils,
except that the nucleus is less
segmented (usually merely indented or
partially lobulated), and granules
are larger and have a strong affinity for basic
stains

Basophils are the least numerous of the

leukocytes in normal blood and
average 0.5%. The 95% reference values for
adults are 0–0.2 − 109/L
 NEUTROFIL
Neutrophils average 12 mm in diameter;
they are smaller than monocytes
and eosinophils and slightly larger than
basophils.
Neutrophilia or neutrophilic leukocytosis is
an increase in the
absolute count, and neutropenia is a
decrease.
 MONOSIT
The monocyte is the largest cell of normal
blood. It generally
has about two to three times the diameter of
an erythrocyte (14–20 μm)
When the monocyte
transforms into a macrophage, it becomes
larger (20–40 μm); the nucleus
may become oval and the chromatin more
reticular or dispersed, so that
nucleoli may be visible. A perinuclear clear
zone (Golgi) may be evident

Monocytes average 4% of leukocytes, and

the reference interval for
adults is approximately 0–0.8  109/L,
 LIMFOSIT
Lymphocytes are mononuclear cells without
specific cytoplasmic granules.
Small lymphocytes are about the size of an
erythrocyte or slightly larger
(6–10 μm)

Lymphocytes average 34% of all leukocytes and

range from 1.5–4 ×
109/L in adults. The lymphocytes and their
derivatives, the plasma cells,
operate in the immune defenses of the body.
Trombosit
Platelets are thin disks, 2–4 μm in diameter and 5–7 fL in
volume (in citrated blood). They function in hemostasis, in
maintenance of vascular integrity, and in the process of blood
coagulation. Reference values for platelet counts are 150–450
× 109/L.
LED
Golongan Darah
Rhesus
Bleeding Time
Clotting Time
PT/APTT
Retraksi Bekuan
SADT
G6PD
Hb Elektroforesis
Agregasi Trombosit
TIBC
Rumple Leed
 GAMBARAN HEMATOLOGI

INFEKSI

ANEMIA

PERDARAHAN

KEGANASAN

ITP, ATP
 GAMBARAN HEMATOLOGI
PENYAKIT POPULER

INFEKSI ANEMIA
• NUTRISI
• BAKTERI
• HEMORAGIK
• VIRUS
• HEMOLITIK
• PARASIT
• APLASTIK

PERDARAHAN KEGANASAN

ITP, ATP
 GAMBARAN HEMATOLOGI
PENYAKIT POPULER

• INFEKSI • PERDARAHAN
• Bakteri (Thyphoid, Pertusis) • Hemofilia
• Virus (DHF, HIV) • APCD
• Parasit (Cacing) • KEGANASAN
• ANEMIA • Preleukemia
• Nutrisi (ADB) • Leukemia
• Hemoragik • ITP, ATP
• Hemolitik (Thalassemia,
G6PD)
• Aplastik (Gangguan Bone
Marrow)
ANEMIA