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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

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 each other are as follows:

  • 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 each other are as follows:

  • Red cells should be assessed as to their:

    • number

    • size

    • shape

    • degree of haemoglobinization

    • distribution in the blood film.




  • Anaemia normal (caused by iron deficiency)





  • Assessing red cell size: normal

    -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.






  • Assessing red cell shape ( normal 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

Diagrammatic representation of different types of poikilocyte




  • Numerous poikilocyteelliptocytes and ovalocytes (in hereditary

    elliptocytosis).


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


  • Numerous poikilocytestomatocytes (in hereditary stomatocytosis).


  • Several poikilocytekeratocytes (in microangiopathichaemolyticanaemia);

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


  • Several poikilocyteschistocytes (red cell fragments) including a

    microspherocyte (in haemolyticuraemic syndrome)


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








  • Training Questions : cell

  • What are the red cell indices formulae ?

  • Mention the different red cell shapes .

  • How to assess red cells regarding their size ?


Reference book cell

- Dacie

- Essential Haematology


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