Biochemistry – Hematologic Analyses


The complete blood count includes determining the total number of all cell elements of blood (erythrocytes, leukocytes and platelets), the amount of hemoglobin, hematocrit, leukocyte formula, and the parameters like MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin) and MCHC (mean corpuscular hemoglobin concentration). Most of the parameters are determined by the hematology analyzer, and some of them are calculated with a computer program.


Low hemoglobin indicates to anemia. However, to determine a type of anemia and, consequently, apply adequate treatment, it is not sufficient only to have hemoglobin results. It is also necessary to determine the total number of RBC, MCV, MCH and MCHC. Only when we have obtained these results will be able to differentiate whether this is related to hypochromic or normochromic anemia or anemia due to the lack of iron, folates or vitamin B12 (also to be determined).


Blood sedimentation is the rate of erythrocyte sedimentation caused by the gravity over a period of half an hour or 1 hour. During an inflammation, an increase in the concentration of fibrinogen and other proteins in the acute phase leads to more rapid sedimentation of erythrocytes, which results in increased erythrocyte sedimentation. Markedly increased sedimentation from 50 to 100 may be obtained in malignant diseases.


White blood cells are a cellular part of the immune defense of the body. Therefore, some pathological conditions such as infections of specific organs or tissues, are always accompanied by an increase in the total number of white blood cells (the body defends itself from the infection in that way). Beside in infections, the number of leukocytes may markedly increase in leukemia (malignancy of white blood cells).


The number of leukocytes may physiologically vary depending on age, physical exercise, pregnancy, stress and other conditions. The total number of leukocytes is the sum of all forms of leukocytes which are separated in the differential leukocyte formula which is issued in the absolute number and percentage for each of 5 types of leukocytes. If the total number is higher than the upper reference value, this usually indicates to an infection. If neutrophils (granulocytes) are increased, this usually indicates to a bacterial infection, and in the case of increased lymphocytes, the cause is usually a viral infection.


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