Complete Blood Count (CBC) with Differential and Platelets Blood Test

When is a Complete Blood Count test ordered?  

A CBC test may be ordered in various situations. These include:

1. Routine Check-ups: Doctors often include a CBC test as part of routine check-ups to assess overall health and screen for any underlying blood-related conditions.
2. Evaluation of Symptoms: When a patient presents unexplained symptoms such as fatigue, weakness, frequent infections, bruising, or excessive bleeding, a CBC test can help identify potential causes or abnormalities.
3. Monitoring Chronic Conditions: Patients with chronic conditions like anemia, infections, autoimmune disorders, or blood-related diseases require regular CBC tests to monitor their condition, track treatment effectiveness, and adjust therapies accordingly.
4. Pre-Surgical Assessment: Prior to surgery or invasive medical procedures, doctors order CBC tests to evaluate a patient’s blood cell counts and ensure their ability to handle the procedure safely.

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances.

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person’s blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells.

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results.

The CBC focuses on three different types of cells:

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count.

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity.

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances.

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC.

Lab tests often ordered with a Complete Blood Count test: 

1. Basic Metabolic Panel (BMP) or Comprehensive Metabolic Panel (CMP):
   • Purpose: These panels measure glucose, calcium, and electrolytes (sodium, potassium, carbon dioxide, chloride), and kidney function (blood urea nitrogen (BUN) and creatinine). The CMP includes additional tests for liver function (ALP, ALT, AST, bilirubin).
   • Why is it ordered with a CBC: These panels provide a general overview of a person’s metabolism and organ function and can help determine the cause of symptoms like fatigue or weakness that might be related to abnormalities found on a CBC.
2. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP):
   • Purpose: These are markers of inflammation in the body. They are not specific but can indicate the presence of an inflammatory process.
   • Why is it ordered with a CBC: If a CBC shows abnormalities such as an elevated white blood cell count, these tests can help determine if inflammation or infection is present.
3. Coagulation tests (Prothrombin Time (PT), International Normalized Ratio (INR), Activated Partial Thromboplastin Time (aPTT)):
   • Purpose: These tests assess blood clotting function and are important if the platelet count or function is abnormal, or if there is a concern about bleeding or clotting disorders.
   • Why is it ordered with a CBC: Abnormal platelet counts from a CBC could signal a bleeding or clotting disorder that would warrant these tests.
4. Iron studies (Serum iron, Ferritin, Transferrin, Total Iron-Binding Capacity (TIBC)):
   • Purpose: These tests measure different aspects of the body’s iron storage and transport and can help diagnose iron-deficiency anemia or hemochromatosis (iron overload).
   • Why is it ordered with a CBC: If the CBC indicates anemia, particularly microcytic anemia (small red blood cells), iron studies can help determine if iron deficiency is the cause.
5. Vitamin B12 and Folate levels:
   • Purpose: These vitamins are crucial for the production of red blood cells, and their deficiency can cause macrocytic anemia (large red blood cells).
   • Why is it ordered with a CBC: If the CBC shows macrocytosis, measuring B12 and folate levels can help find the underlying issue.
6. Lactate Dehydrogenase (LDH):
   • Purpose: LDH is an enzyme found throughout the body, and high levels can indicate cell damage.
   • Why is it ordered with a CBC: Elevated LDH may accompany certain types of hemolytic anemia or other conditions that cause a high turnover of cells, which could be suggested by a CBC.
7. Reticulocyte Count:
   • Purpose: This test measures the number of young red blood cells in the blood, providing information about bone marrow function.
   • Why is it ordered with a CBC: A reticulocyte count can help determine if the bone marrow is responding appropriately to anemia by producing new red blood cells.

The specific tests ordered alongside a CBC with differential and platelets will depend on the clinical scenario, the initial CBC results, and the suspected or differential diagnoses that the healthcare provider is considering.

Conditions where a Complete Blood Count test is recommended: 

A CBC test can assist in diagnosing and monitoring various conditions or diseases, including:

1. Anemia: CBC helps identify different types of anemia, such as iron deficiency anemia, vitamin B12 deficiency anemia, or autoimmune hemolytic anemia.
2. Infections: An abnormal CBC count can indicate the presence of an infection, whether bacterial, viral, or fungal. It provides information about the severity and type of infection.
3. Leukemia: CBC abnormalities may suggest the presence of certain blood cancers, including leukemia. Further tests are necessary to confirm the diagnosis.
4. Inflammatory Disorders: Conditions like rheumatoid arthritis, lupus, or vasculitis can cause changes in the CBC results, indicating ongoing inflammation or autoimmune processes.

How does my healthcare provider use a Complete Blood Count test? 

Health care providers use the results of a CBC test to:

1. Confirm Diagnoses: Abnormal CBC findings help in diagnosing specific conditions or diseases, such as anemia, infections, blood disorders, or certain cancers.
2. Monitor Treatment Progress: Regular CBC tests allow doctors to evaluate the effectiveness of treatments or therapies and make necessary adjustments based on blood cell count improvements or changes.
3. Guide Further Investigations: If CBC results indicate abnormalities, doctors may recommend additional specialized tests or refer the patient to a hematologist or other relevant specialists for further evaluation and diagnosis.

By understanding the purpose, significance, and applications of a CBC test, patients and healthcare providers can utilize this valuable diagnostic tool to aid in the management of various health conditions and ensure optimal patient care.

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health.

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders, including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders, including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your healthcare provider, who can provide an interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health.

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders, including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders, including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your healthcare provider, who can provide an interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health.

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You:  order your tests,  get your blood drawn, and then  receive your results on-line.

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3. Review your test results and biomarkers online.

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4. Track your progress; consult with your healthcare provider and retest.

   • Your personalized health dashboard makes it easy to view diagnostic changes that occur between blood tests, allowing you to adjust your wellness plan for even better health.
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