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Complete blood count

life science Maturity 7-9 Next article →

A complete blood count, often called a CBC, is a vital medical laboratory test. It provides detailed information about the various cells found in a person's blood.

Blausen 0425 Formed Elements
Blausen 0425 Formed Elements

This test is one of the most common procedures in medicine today. Doctors use it to monitor general health or to help diagnose specific diseases. It can also be used to track how a patient responds to medical treatments. Because blood changes can reflect issues in many different organ systems, the CBC is a very versatile tool for healthcare providers.

The test evaluates the cellular components of the blood, which include red blood cells, white blood cells, and platelets.

Red blood cells are the most numerous and carry oxygen throughout the body. White blood cells are essential parts of the immune system that fight off threats. Platelets are small cell fragments that help the blood form clots to prevent excessive bleeding. The CBC also measures hemoglobin, which is the protein in red cells that carries oxygen. Additionally, it calculates the hematocrit, which is the volume percentage of red blood cells in the total blood volume.

Modern laboratories usually perform these tests using an automated hematology analyzer.

Sysmex XT-4000i
Sysmex XT-4000i

The process begins by agitating the blood sample to ensure the cells are evenly distributed. The machine then dilutes the sample and moves it into different channels. One channel typically counts red blood cells and platelets. Another channel counts white blood cells and measures hemoglobin concentration. To improve accuracy, many machines use hydrodynamic focusing. This technique injects the sample into a low-pressure fluid stream. This causes the cells to line up in single file through laminar flow, allowing sensors to measure them one by one.

A major breakthrough in this technology is the Coulter principle.

Particle Transit Channel
Particle Transit Channel

Patented by Wallace H. Coulter in 1953, this method uses electrical impedance to analyze cells. When a cell passes through a small opening in a conductive medium, it causes a temporary drop in electrical current. The size of this current drop is proportional to the volume of the particle. This allows the machine to count cells and determine their size simultaneously. In the 1970s, researchers added optical measurements to these systems. These optical tools allowed for the automation of the white blood cell differential, which identifies different types of white cells.

Sometimes, the automated results must be confirmed through a manual blood smear review. This occurs in approximately 10% to 25% of all samples. During this process, a technician spreads blood on a slide and applies stains.

Iron-deficiency Anemia, Peripheral Blood Smear %284422704616%29
Iron-deficiency Anemia, Peripheral Blood Smear %284422704616%29

These stains make the cells easier to see under a microscope. A professional then examines the cells to ensure the analyzer's results match their actual appearance. This manual step is crucial for spotting abnormalities in cell shape or structure that a machine might miss.

The history of blood counting shows how much technology has advanced. In 1852, Karl Vierordt published the first procedure for counting blood cells by spreading them on a slide. In 1874, Louis-Charles Malassez invented the hemocytometer, which simplified microscopic analysis. Later, in the late 19th century, Paul Ehrlich and Dmitri Leonidovich Romanowsky developed staining techniques that are still used today.

Maxwell Wintrobe furthered the field in 1929 by introducing a method to measure hematocrit and defining red blood cell indices.

CBC results are compared to reference ranges to determine if they are normal. These ranges represent the results found in 95% of healthy people. This means that 5% of healthy people will naturally fall outside the range. Because of this, a result slightly outside the range does not always mean a person is sick. However, specific patterns can indicate serious conditions. For example, low red blood cell counts can indicate anemia, which might be caused by iron or vitamin B12 deficiencies. A white blood cell differential can help identify bacterial, viral, or parasitic infections. It can also assist in diagnosing blood disorders like leukaemia or lymphoma.

Chronic Myeloid Leukemia smear 2009-04-09
Chronic Myeloid Leukemia smear 2009-04-09

Low counts of all three cell types, known as pancytopenia, may suggest a disorder in the bone marrow, which is the system responsible for producing blood cells.

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🖼️ Images & Media (15)
File:Blausen 0425 Formed Elements.png
Blausen 0425 Formed Elements.png
CBC blood test.ogv
File:Sysmex XT-4000i.jpg
Sysmex XT-4000i.jpg
File:Particle Transit Channel.gif
Particle Transit Channel.gif
File:Sysmex WBC scattergrams.jpg
Sysmex WBC scattergrams.jpg
File:Packed cell volume diagram.svg
Packed cell volume diagram.svg
File:Iron-deficiency_Anemia,_Peripheral_Blood_Smear_%284422704616%29.jpg
Iron-deficiency_Anemia,_Peripheral_Blood_S...
File:Chronic Myeloid Leukemia smear 2009-04-09.JPG
Chronic Myeloid Leukemia smear 2009-04-09.JPG
File:Essential Thrombocythemia, Peripheral Blood (10189570483).jpg
Essential Thrombocythemia, Peripheral...
File:Reticulocytes_Human_Blood_Supravital_Stain.jpg
Reticulocytes_Human_Blood_Supravital_Stain.jpg
File:Neonate Blood Smear.JPG
Neonate Blood Smear.JPG
File:Red blood cell agglutination due to cold agglutinin.jpg
Red blood cell agglutination due to cold...

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