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Serological Investigations

Haematological

FBC

Haemoglobin (11.5 - 16.5g/dl)
RBC (4.0 - 5.5 x1012/l)
Reticulocytes (less than 1%)
PCV (35 - 47%)
MCV (81 - 99fl)
Platelets (150 - 450 x109/l)
White Cell Count (4.0 - 11.0 x109/l)
Neutrophils (2.2 - 7.7 x109/l) ~ 60 - 70%
Lymphocytes (1 - 3.5 x 109/l) ~ 25 - 35%
Monocytes (1.6 - 1.8 x 108/l) ~ 4 - 8%
Eosinophils (less than 0.45 x 109/l) ~ 1 - 4%

Red Blood Cells

Earliest precursor in the marrow is the pre-erythroblast and maturation proceeds through the stages of normoblast in which there is progressive condensation of the nuclear chromatin and the development of haemoglobin in the cytoplasm.

Disappearance of the nucleus completes the formation of the young erythrocyte (reticulocyte) which is larger than the mature form and has a faintly bluish colour with Romanowsky stains and still contains fine reticular material.

The mature erythrocyte stains as an eosinophilic, circular biconcave disc with a diameter of 7.2 microns.

The presence of normoblasts in blood indicates excessive or abnormal blood formation or irritation of the bone marrow.

Excessive reticulocytes reflects increased erythropoiesis.

Haemoglobin is the oxygen transport system of blood and in the normal adult consists of four paired polypeptide chains, 2 alpha chains of 141 amino acids and 2 beta chains of 146 amino acids.

B12 and folate are required in the maturation of red blood cells, a deficiency state results in an increased proportion of immature blood cells in the circulation resulting in a macrocytic anaemia.

Iron is essential in the synthesis of haemoglobin and a deficiency results in over mature small red blood cells in the circulation and a microcytic anaemia.



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