Complete Blood Count
임상에서 가장 흔히 시행되는 검사
• 임상에서 가장 흔히 시행되는 검사
• 혈액학적 평가의 기본검사혈액학적 평가의 기본검사
• 골수 기능에 대한 정보 제공
• 혈액질환의 진단에 중요한 정보 제공
• 혈액질환의 진단에 중요한 정보 제공
• 현재 완전 자동화 되어있고 재현성이 높음
Differential Diagnosis Of Anemia Differential Diagnosis Of Anemia
Use MCV and RDW
Low MCV Normal MCV High MCV
RDW<15 Th l i t it ACD A l ti i
RDW<15 Thalassemia trait Hetero HbE, HbC, Anemia of chronic
ACD
Heterozygous HbS, HbCS, HbE
Aplastic anemia MDS
Myeloma disease (ACD) H. spherocytosis
Acute hemorrhage
Liver disease Hyperthyroidism RDW>15 Iron deficiency anemia Early or combined B12 deficiency RDW>15 Iron deficiency anemia
Thalassemia intermedia Sideroblastic anemia
S ACD
Early or combined nutritional deficiency Myelodysplasia
M l hthi i
B12 deficiency Folate deficiency AIHA
D HU ARV
Severe ACD
RBC fragmentation
Myelophthisis
Sickle cell anemia Homozygous HbCS
Drugs: HU, ARV, AZA, etc.
Erythrocytosis (Hb>18 (M), Hb>16 (F))
Primary (low EPO)
Erythrocytosis (Hb 18 (M), Hb 16 (F))
Primary (low EPO)
Polycythemia vera Secondary (high EPO) Secondary (high EPO)
High affinity hemoglobin
Hypoxia : COPD cyanotic heart disease Hypoxia : COPD, cyanotic heart disease,
sleep apnea, high altitude Inapproate erythropoietin synthesis Inapproate erythropoietin synthesis
Renal disease : renal cell carcinoma, PCKD RA stenosis, post-transplant polycythemia, p p p y y Others : cerebellar hemangioblastoma,
hepatoma, myoma, meningioma, p y g Cushing's syndrome, androgen
Inaccurate Estimates Of Hb RBC MCV Inaccurate Estimates Of Hb, RBC, MCV
High Hb High WBC, hyperlipidemia, paraproteinemia, cryoglobulinemia
High RBC High WBC, Numerous large platelets, hyperlipidemia, cryoglobulinemia
Low RBC Cold agglutinin, EDTA-dependent agglutination,
f C
extreme microcytosis, fragmented RBC
High MCV Storage at RT, cold agglutinin, EDTA-dependent l ti ti hi h WBC h l it
agglutination, high WBC, hyperosmolarity
Low MCV Hypochromic red cell, increased temperature, h po osmaolarit
hypo-osmaolarity
Neutropenia
Infection Viral (measles mumps rubella)
Neutropenia
Infection Viral (measles, mumps, rubella)
Bacterial (typhoid, Gram (-) infection) Rickettsial
Rickettsial
Drugs Chemotherapy, antithyroid drugs,
sulphonamide vancomycin cephalosporine sulphonamide, vancomycin, cephalosporine phenytoin, valproate, chlorpromazine,
interferon, rituximab, imatinib interferon, rituximab, imatinib Radiation therapy
Aplastic anemiap
Autoimmune neutropenia Cyclical neutropeniay p
Constitutional (idopathic) Alcoholism
Mild Thrombocytopenia (>80K)
I f ti (VIRAL b t i l)
Mild Thrombocytopenia (>80K)
Infection (VIRAL, bacterial) Drugs
tibi ti NSAID ti l ti i tidi
antibiotics, NSAID, antineoplastics, cimetidine, phenytoin, valproic acid, thiazide
Chronic alcoholism Chronic alcoholism
Autoimmune disease (SLE) Hypersplenism
Hypersplenism
Marked Thrombocytosis
Myeloproliferative neoplasm Malignant disease
Post-splenectomy p y Infection
Inflammation Inflammation
Connective tissue disorder Iron deficiency
Iron deficiency
Trauma or tissue damage
P t i
Fanconi's anemia
Pancytopenia
Fanconi s anemia
Aplastic anemia, PNH
Bone marrow infiltration of malignant cells Bone marrow infiltration of malignant cells
Acute leukemia, myeloma, carcinoma, lymphoma Myelodysplastic syndrome
Myelodysplastic syndrome Idiopathic myelofibrosis
Acquired immune deficiency syndrome(AIDS) Acquired immune deficiency syndrome(AIDS) Graft-versus-host disease
Drugsg
Chemotherapy, PAS, sulfonamide, rifampicin Hypersplenismyp p
Alcohol toxicity
