Course title : Hematology (1)
Course code : MLHE- 201
Supervisor: Prof. Dr Magda Sultan
Date :10/10/2013
Outcome :
The student will know :
The importance of Hemoglobin.
The importance of Hematocrit .
How to calculate the red cell
indices?
Red Blood Cells
• Haemoglobin concentration
• If red cells are lysed, the haemoglobin is
released
from the red cells and forms a solution in the
plasma. The haemoglobin concentration (Hb)
can be measured biochemically by light
absorption at a specified wave length after a
chemical reaction which converts haemoglobin
to cyanmethaemoglobin .
• Hb is measured in either grams per decilitre
(g/dl) or grams per litre (g/l).
A fall in the Hb is referred to as anaemia.
• Haematocrit or packed cell volume
• An alternative way of detecting anaemia is to
centrifuge a tube containing an aliquot of
blood and measure the proportion of the
column of blood which is occupied by the red
cells.
• This test is called a packed cell volume (PCV)
or a
• haematocrit (Hct).
• This measurement is expressed as a decimal
percentage, i.e. as litres/litre (e.g. 0.45).
• Red cell indices
• Red cells can vary in their size and in the amount of haemoglobin
contained in an individual cell.
•
Diagnostically useful informations can be obtained by measuring
the red cell indices :
Mean cell volume (MCV).
Mean cell haemoglobin (MCH).
Mean cell haemoglobin concentration (MCHC).
•
The formulae which relate the various red cell indices to each other are as
follows:
MCV is measured in femtolitres
MCH is measured in picograms
MCHC is measured in g/dl
• Normal ranges
• In order to interpret blood counts it is
necessary to know what is normal. This is
usually done by reference to either a normal
or a reference range.
• Assessing Red Cells
• Red cells should be assessed as to their:
• number
• size
• shape
• degree of haemoglobinization
• distribution in the blood film.
• Assessing red cell number and distribution
-Anaemia
-Polycythaemia
- Rouleaux formation
- Red cell agglutination
• Normal distribution of red cells in a healthy
subject with normal Hb.
• Anaemia (caused by iron deficiency)
• Polycythaemia.
• Rouleaux
• Red cell agglutinates
• Assessing red cell size:
-Microcytosis.
-Macrocytosis.
-Anisocytosis.
• If cells are smaller than normal they are described as microcytic and if
larger than normal as macrocytic.
• Red cells of normal size are said to be normocytic.
• If red cells show greater variation in size than normal the blood film is said
to show anisocytosis .
•
•
• Normocytic red cells.
•
• Microcytic red cells (MCV 62fl )
• Macrocytic red cells (MCV 105 fl)
• Anisocytosis
• Assessing red cell shape (poikilocytosis)
•
• If red cells show more than the normal degree
of variation in red cell shape there is said to be
poikilocytosis
Diagrammatic representation of different types of poikilocyte
• Moderate numbers of spherocytes (in
hereditary spherocytosis
• Several irregularly contracted cells (in haemoglobin C
disease).
• The majority of the other cells are target cells.
• Numerous elliptocytes and ovalocytes (in hereditary
elliptocytosis).
• Several dacrocytes (tear-drop poikilocytes) (in
idiopathic myelofibrosis).
• Numerous stomatocytes (in hereditary
stomatocytosis).
• Several keratocytes (in microangiopathic haemolytic
anaemia);
• keratocytes are sometimes called ‘bite cells’ because
they look as if a bite has been taken from them
• Several schistocytes (red cell fragments) including a
microspherocyte (in haemolytic uraemic syndrome)
• Echinocytes (crenated cells) (in chronic renal failure)
• Acanthocytes (in abetalipoproteinaemia
• One sickle cell and several boat-shaped cells (in sickle
cell anaemia )
• Assessing red cell colour:
- Normochromic
- Hypochromic
• Normochromic red cells
• Hypochromic red cells
‫‪Assignment‬‬
‫‪Assignment‬‬
‫‪Counting chamber in cell counts‬‬
‫‪.‬‬
‫‪Red cell assessment .‬‬
‫‪Students names‬‬
‫الشيماء مصطفي عبد العاطي‬
‫امل محمد احمد‬
‫اميره اسعد يوسف‬
‫اميره صالح مرشدي‬
‫انجي عبد الموجود‬
‫اوركيد اشرف‬
‫ايمان سعيد محمد‬
‫ايمان محمدي يوسف‬
‫ايه رجب عبد العزيز‬
‫ايه حماده عطيه‬
‫ابانوب عوض ناجي‬
‫باخوم سدراك نظير‬
‫باسم خالد محمد‬
‫بسمه مهدي رياض‬
‫بسنت اشرف محمد‬
‫بسنت حسن علي‬
‫تغريد محمود ابراهيم‬
‫حسام الدين حسين‬
‫حسام حسين منصور‬
‫حماده محمد عشري‬
• Training Questions :
• What are the red cell indices formulae ?
• Mention the different red cell shapes .
• How to assess red cells regarding their size ?
Reference book
- Dacie
- Essential Haematology