• Dr Stella E. Okereke-Nwokeji

Hematology studies

ESR (Erythrocyte Sedimentation Rate - It is a nonspecific screening test that indirectly measures how much inflammation is in the body. This test can be used to monitor inflammatory or cancerous diseases. It cannot be used to diagnose a specific disorder although it is used in detecting and monitoring tuberculosis, tissue death, certain forms of arthritis, autoimmune disorders and some inflammatory diseases.

The ESR (sedimentation rate for short) is the rate at which red blood cells sediment to the bottom of a tube in a period of one hour. It is a common hematology test. Anticoagulated blood is placed in a Westergren tube (it's an upright tube) and the rate at which the red blood cells fall is measured and reported in mm/h.

An increased SED rate (ESR) may be due to anemia, kidney disease, osteomyelitis, pregnancy, rheumatic fever, rheumatoid arthritis, syphilis, systemic lupus erythematosus, thyroid disease, tuberculosis or other inflammatory conditions.

A very high SED rate (ESR) may occur with giant cell arteritis, hyperfibrinogenemia (increased fibrinogen levels in the blood), multiple myeloma, macroglobulinemia - primary, necrotizing vasculitis or polymyalgia rheumatica.

Lower than normals levels may be due to congestive heart failure (CHF), hyperviscosity, hypofibrinogenemia (decreased fibrinogen levels), low plasma protein (due to liver or kidney disease), polycythemia or sickle cell anemia.

ESR (male): 0 - 15 mm/hr ESR (female): 0 - 20 mm/hr

HEMATOCRIT (HCT)- The hematocrit refers to the 'percentage' of one's red blood cells.

Normal Adult Female Range: 36 - 46 percent Normal Adult Male Range 41 - 53 percent Normal Newborn Range: 49 - 61 percent

HEMOGLOBIN (HGB) - Hemoglobin is a protein that is carried by red cells. It picks up oxygen in the lungs and delivers it to the peripheral tissues to maintain the viability of cells. Hemoglobin is made from two similar proteins that "stick together". Both proteins must be present for the hemoglobin to pick up and release oxygen normally. One of the component proteins is called alpha, the other is beta. Before birth, the beta protein is not expressed. A hemoglobin protein found only during fetal development, called gamma, substitutes up until birth. Normal Adult Female Range: 12.0 - 16.0 g/dL Normal Adult Male Range: 13.5 - 17.5 g/dL Normal Newborn Range: 14 - 20 g/dL

MCH (Mean Corpuscular Hemoglobin) - Hemoglobin amount per red blood cell is the MCH.

Normal Adult Range: 25.4 - 34.6 pg/cell Optimal Adult Reading: 30

MCV (Mean Corpuscular Volume) - Average red blood cell size is MCV.

Normal Adult Range: 80 - 100 fl Optimal Adult Reading: 90 Higher ranges are found in newborns and infants

MCHC (Mean Corpuscular Hemoglobin Concentration) - Hemoglobin concentration (hemoglobin amount relative to the size of the cell) per red blood cell.

Normal Adult Range: 31 - 36 Hb/cell Optimal Adult Reading: 34 Hb/cell Higher ranges are found in newborns and infants

RBC - (Red Blood Cell Count aka Erythrocyte count)

RBC count (female) 3.5 - 5.5 mill/mm3 RBC count (male) 4.3 - 5.9 mill/mm3 RBC volume (female) 19 - 31 mL/kg RBC volume (male) 20 - 36 mL/kg Lower ranges are found in Children, newborns and infants

WBC - (White Blood Cell Count aka Leukocyte count)

Includes Basophils, Neutrophils, Eosinophils, B Cells, T Cells, Band Cells, Monocytes

Normal Adult Range: 4,000 - 12,000/mm3 Higher ranges are found in children, newborns and infants.

PLATELET COUNT - aka Thrombocyte Count

Normal Adult Range: 150,000 - 400,000/mm3 Higher ranges are found in children, newborns and infants

NEUTROPHILS and NEUTROPHIL COUNT - (This is the main defender of the body against infection and antigens. High levels may indicate an active infection.)

Normal Adult Range: 54 - 62 percent

LYMPHOCYTES and LYMPHOCYTE COUNT - (Elevated levels may indicate an active viral infections such as measles, rubella, chickenpox, or infectious mononucleosis.)

Normal Adult Range: 25 - 33 percent

MONOCYTES and MONOCYTE COUNT - (Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia 'monocytic' or lymphomas.)

Normal Adult Range: 3 - 7 percent

EOSINOPHILS and EOSINOPHIL COUNT - (Elevated levels may indicate an allergic reactions or parasites.)

Normal Adult Range: 1 - 3 percent

BASOPHILS and BASOPHIL COUNT - (Basophilic activity is not fully understood but it is known to carry histamine, heparin and serotonin. High levels are found in allergic reactions.)

Normal Adult Range: 0 - 0.75 percent