Course title : Hematology (1)
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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

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Course title : Hematology (1) Course code : MLHE- 201 Supervisor: Prof. Dr Magda Sultan

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Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

Course title : Hematology (1)

Course code : MLHE- 201

Supervisor: Prof. Dr Magda Sultan

Date :10/10/2013


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

Outcome :

The student will know :

The importance of Hemoglobin.

The importance of Hematocrit .

How to calculate the red cell indices?


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

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 .


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • 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.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • 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).


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • 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).


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

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


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • 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.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Assessing Red Cells

  • Red cells should be assessed as to their:

    • number

    • size

    • shape

    • degree of haemoglobinization

    • distribution in the blood film.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Assessing red cell number and distribution

    -Anaemia

    -Polycythaemia

    - Rouleaux formation

    - Red cell agglutination


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Normal distribution of red cells in a healthy subject with normal Hb.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Anaemia (caused by iron deficiency)


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Polycythaemia.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Rouleaux


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Red cell agglutinates


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Assessing red cell size:

    -Microcytosis.

    -Macrocytosis.

    -Anisocytosis.

  • If cells are smaller than normal they are described as microcyticand 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.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Normocytic red cells.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Microcytic red cells (MCV 62fl )


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Macrocytic red cells (MCV 105 fl)


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Anisocytosis


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • 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


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

Diagrammatic representation of different types of poikilocyte

Diagrammatic representation of different types of poikilocyte


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Moderate numbers of spherocytes (in hereditary spherocytosis


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Several irregularly contracted cells (in haemoglobin C disease).

  • The majority of the other cells are target cells.


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Numerous elliptocytes and ovalocytes (in hereditary

    elliptocytosis).


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Several dacrocytes (tear-drop poikilocytes) (in idiopathicmyelofibrosis).


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Numerous stomatocytes (in hereditary stomatocytosis).


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Several keratocytes (in microangiopathichaemolyticanaemia);

  • keratocytes are sometimes called ‘bite cells’ because they look as if a bite has been taken from them


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Several schistocytes (red cell fragments) including a

    microspherocyte (in haemolyticuraemic syndrome)


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Echinocytes (crenated cells) (in chronic renal failure)


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Acanthocytes (in abetalipoproteinaemia


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • One sickle cell and several boat-shaped cells (in sickle cell anaemia )


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Assessing red cell colour:

    - Normochromic

    - Hypochromic


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Normochromic red cells


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Hypochromic red cells


Assignment

Assignment


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

  • Training Questions :

  • What are the red cell indices formulae ?

  • Mention the different red cell shapes .

  • How to assess red cells regarding their size ?


Course title hematology 1 course code mlhe 201 supervisor prof dr magda sultan

Reference book

- Dacie

- Essential Haematology


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