Indicator Norma

Erythrocytes Male 4-6*1012/L

Female 3,8-4,7*1012/L
Hemoglobin Male 4-6*1012/L
Female 3,8-4,7*1012/L
HCT (hematocrit) Male 40-54%
Female 37-47%
MCV (mean corpuscular volume) 80-100 fL (femtoliter): increased – macrocystic anemia;
Decreased – microcystic anemia
MCH (mean corpuscular hemoglobin) 27-32 pg/l (picrogram): increased – macrocystic
anemia; Decreased – microcystic anemia
MCHC (mean corpuscular hemoglobin 31-37 g/gl (normal – normochromic anemia; Decreased
concentration) – hypochromic anemia)
Reticulocytes 1,2-2,0 %
Leucocytes 4-9*109/L
Thrombocytes (Platelets) 180-320*109/L
Myeloblasts -
Myelocytes -
Metamyelocytes -
Juvenile neutrophils 0-1%
Band (stab) neutrophilic cells (0,004-0,3*109/l ) 1-6%
Neutrophils (2-5,5*109/l ) 40-72%
Basophils (0-0,1*109/l ) 0-1%
Eosinophils (0-0,4*109/l ) 0-5%
Lymphocytes (1,5-4,0*109/l ) 18-40%
Monocytes (0,2-0,8*109/l ) 3-11%
Eruthrocyte sedementaion rate 2-10 mm/hr (aged more than 50 years – till 15 mm/hr)

“Left shift” – increased number of band (stab) neutrophils due to inflammation or severe infection.

“Right shift” - in the ratio of immature to mature neutrophils is considered with reduced count or lack of
"young neutrophils" (metamyelocytes, and band neutrophils) in blood smear, associated with the
presence of "giant neutrophils". This fact shows suppression of bone marrow activity, as a hematological
sign specific for pernicious anemia and radiation impact.

Leukemia is a group of blood cancers that usually begin in the bone marrow and result in high numbers
of abnormal blood cells. These blood cells are not fully developed and are called blasts or leukemia cells.

Symptoms: pain in different parts of body, fever, fatigue, bruits, bleeding, increased risk of infection.
Leukemia can be acute and chronic, also can be classified according to type of cell invasion:
(Lymphocystic leukemia, Neutrophilic leukemia and etc.)
Acute Chronic
Mostly in children Mostly in people aged 40-50 years
Prevalence of blasts cells (myelo-lymphoblasts) Prevalence of myelo-methamyelocytes
 Leukocytosis (>9x10*9/l):
Physiological: Pathological:
Stress Infection diseases, mainly bacterial ethiology
(pneumonia, abscess, pyelonephritis,
cholecystitis, sepsis, tonsillitis)
Physical exercise Autoimmune diseases – connective tissue
diseases (rheumatoid arthritis, systemic lupus,
spondilitis, gout)
Pregnancy Burns
Smoking Traumas, injuries
Specific diet Tumors
State after surgical intervention Leucosis – leukemia (leucosis) – leukemic
leucosis
reaction to some drug such as steroids, Myocardial infarction
lithium, and some inhalers
Thrombosis of different location
Uremic and diabetic coma
Splenectomy
Massive bleeding
State after surgical intervention
Toxic impact to

*** Pathological leukocytosis – neutrophilia

Leukopenia (<4x10*9/l )
 Aplastic anemia
 Myelodysplastic syndromes (general decrease of erythrocytes, leukocytes, plateles)
 Myeloproliferative syndrome (group of tumours in which immature blood cells in the bone
marrow do not mature, so do not become healthy blood cells) – increase of blast cells.
 Chemotherapy, radiation therapy Congenital problems
 Infectious diseases (HIV, tubercolosis)
 Autoimmune disorders (lupus, rheumatoid arthritis)
 Malnutrition
 Medications that can cause leukopenia include:
o bupropion (Wellbutrin)
o clozapine (Clozaril)
o cyclosporine (Sandimmune)
o interferons
o lamotrigine (Lamictal)
o minocycline (Minocin)
o mycophenolate mofetil (CellCept)
o penicillin
o sirolimus (Rapamune)
o sodium valproate
o steroids
o tacrolimus (Prograf)
 Sarcoidosis
 Lymphocytosis (>4.0x10*9/l or >40%): Lymphopenia (<1.6x10*9/l or <16%):

acute viral infections (TORCH infection, Corticosteroid use

hepatitis)
some protozoal infections (toxoplasmosis)  Infections  (HIV, influenza, Covid-19 (severe
course),  bacterial, and fungal agents)
chronic intracellular bacterial infections  Malnutrition
(tuberculosis or brucellosis)
lymphomas Autoimmune diseases (systemic lupus
erythematosus,  rheumatoid
arthritis, sarcoidosis, multiple sclerosis)
acute viral infections (TORCH infection, Consequances after chemotherapy, such as
hepatitis) with cytotoxic agents or immunosuppressive
drugs intake.
endocryne diseases (thyrotoxicosis,Addison`s
disease)

Eosinophilia (>5x10*9/l Monocytosis (>10x10*9/l or >10-11%) Basophilia (>1x10*9/l or

or >5%) >1%)
Allergies and asthma Infections: tuberculosis, brucellosis, subacut Infections
e bacterial endocarditis, syphilis, and other
viral (infection mononucleosis caused by
VEB), protozoal and rickettsial infections
Drug allergy Blood and immune causes: Allergies
chronic neutropenia and myeloproliferative
disorders.
Infections (mostly from Autoimmune Disorders and diseases
parasites) diseases and vasculitis: systemic lupus characterized by
erythematosus, rheumatoid chronic inflammation
arthritis and inflammatory bowel disease.
Blood disorders and Tumours: chronic myelomonocytic myeloproliferative disorders
tumors leukaemia (CMML) and monocytic
leukemia.
Autoimmune disease Obesety
Sarcoidosis
Anemia

Anemia is a condition in which the lack enough healthy red blood cells prevents to carry
adequate oxygen to your body's tissues.
Types
- Aplastic anemia - Iron deficiency anemia - Sickle cell anemia
- Thalassemia - Vitamin deficiency anemia
Symptoms
Anemia signs and symptoms vary depending on the cause. If the anemia is caused by a chronic
disease, the disease can mask them, so that the anemia might be detected by tests for another
condition
 Fatigue, Weakness
 Pale or yellowish skin
 Irregular heartbeats
 Shortness of breath
  Dizziness or lightheadedness
 Chest pain
 Cold hands and feet
 Headache
Causes of anemia
Different types of anemia have different causes.
 Iron deficiency anemia. This most common type of anemia is caused by a shortage of
iron in body. The bone marrow needs iron to make hemoglobin. Without adequate iron,
it can't produce enough hemoglobin for red blood cells. Without iron supplementation,
this type of anemia occurs in many pregnant women. It is also caused by blood loss,
such as from heavy menstrual bleeding, an ulcer, cancer and regular use of some over-
the-counter pain relievers, especially aspirin.
 Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to
produce enough healthy red blood cells. A diet lacking in these and other key nutrients
can cause decreased red blood cell production. Also, some people who consume
enough B-12 aren't able to absorb the vitamin. This can lead to vitamin deficiency
anemia, also known as pernicious anemia.
 Anemia of inflammation. Certain diseases — such as cancer, HIV/AIDS, rheumatoid
arthritis, kidney disease, Crohn's disease and other acute or chronic inflammatory
diseases — can interfere with the production of red blood cells.
 Aplastic anemia. This rare, life-threatening anemia occurs when the bone marrow
doesn't produce enough red blood cells. Causes of aplastic anemia include infections,
certain medicines, autoimmune diseases and exposure to toxic chemicals.
 Anemias associated with bone marrow disease. A variety of diseases, such as leukemia
and myelofibrosis, can cause anemia by affecting blood production in bone marrow. The
effects of these types of cancer and cancer-like disorders vary from mild to life-
threatening.
 Hemolytic anemias. This group of anemias develops when red blood cells are destroyed
faster than bone marrow can replace them. Certain blood diseases increase red blood
cell destruction. It can be acquired or congenital.
 Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic
anemia. It's caused by a defective form of hemoglobin that forces red blood cells to
assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely,
resulting in a chronic shortage of red blood cells.
Iron deficiency Hemolytic Hypoplastic B-12 deficiency
anemia anemia anemia anemia
Hemoglobin Slight decreased decreased decreased decreased
Erythrocytes Slight decreased Slight decreased decreased
decreased
MCV (mean Slight decreased or Slightly Normal increased
corpuscular Normal increased
volume)
MCH (mean Slightly decreased Slightly Normal increased
corpuscular increased
hemoglobin)
MCHC (mean Slightly decreased Normal Normal Slightly increased
corpuscular
hemoglobin
concentration)
Reticulocytes Normal increased decreased Slight decreased

Erythrocytosis
- Increased production of red blood cells by bone marrow
It can be:
Primary: Caused by a disorder of the blood-forming cells. Primary erythrocytosis occurs as a
result of polycythemia vera, a myeloproliferative neoplasm in which abnormal cells in the bone
marrow produce too many red blood cells along with excessive numbers of white blood cells
and platelets. Occasionally, only red blood cell production is increased.

Secondary: Caused by a disorder that triggers increased production by normal blood-forming

cells
Secondary erythrocytosis develops as a result of a disorder that increases erythropoietin
secretion. Erythropoietin is a hormone made in the kidneys that stimulates the bone marrow to
produce red blood cells. As such, secondary erythrocytosis is not considered a
myeloproliferative neoplasm. However, it is important for doctors to look for it because both
primary and secondary erythrocytosis result in too many red blood cells.
Secondary erythrocytosis has many causes. It can be caused by oxygen deprivation, which can
result, for example, from:
- Smoking
- Severe lung disease, such as COPD (chronic obstructive pulmonary disease)
- Severe heart failure
- Birth defects of the heart
- Carbon monoxide poisoning
- High altitude
- Treatment with male hormones such as testosterone
- Kidney problems, including tumors, cysts, and narrowing of the arteries that go to the
kidneys
- Tumors of the liver, brain, or adrenal gland
- Genetic disorders that affect erythropoietin production (congenital erythrocytosis).

Thrombocytosis
Thrombocytosis is a condition with excessive number of platelets in the blood. Platelets are
blood cells in plasma that stop bleeding by sticking together to form a clot. Too many platelets
can lead to certain conditions, including stroke, heart attack, or a clot in the blood vessels.
There are two types of thrombocytosis: primary and secondary. Primary thrombocytosis, also
known as essential thrombocythemia (or ET), is a disease in which abnormal cells in the bone
marrow cause an increase in platelets. The cause is unknown. It is not considered an inherited
(family) condition despite the finding of certain gene mutations in the blood or bone marrow.
Secondary thrombocytosis is caused by another condition the patient may be suffering from,
such as:
 Anemia due to iron deficiency
 Smoking
 COLD (chronic obstructive lung disease)
 Cancer
 Inflammation or infection
 Surgery, especially splenectomy (removal of the spleen)
Secondary thrombocytosis subsides when the underlying process causing the elevated platelet
count resolves (treatment of infection, recovery from surgery, etc.). Even though the platelet
count is elevated for a short time (or even indefinitely after splenectomy), secondary
thrombocytosis does not typically lead to abnormal blood clotting.
Primary thrombocytosis, or essential thrombocythemia, can cause serious bleeding or clotting
complications. These can usually be avoided by maintaining good control of the platelet count
with medications. After many years, however, bone marrow fibrosis (scarring) can develop.
Transformation of the disease to leukemia occurs in a small percentage of patients.
Symptoms and Causes
Most patients do not have any symptoms of an increased platelet count, unless it will form a
blood clot. Symptoms of a blood clot depend on where it’s located:
 arm or leg: tenderness, warmth, swelling, pain
 abdomen: vomiting, diarrhea, severe abdominal pain
 heart: shortness of breath, nausea, light-headedness, sweating, discomfort in the upper
body, chest pain and pressure
 lung: shortness of breath, sweating, fever, coughing up blood, rapid heartbeat, chest
pain
 brain: trouble speaking, vision problems, dizziness, weakness in the face or limbs,
sudden severe headache
Some patients with essential thrombocythemia develop erythromelalgia, causing pain, swelling,
and redness of the hands and feet, as well as numbness and tingling.
Diagnosis and Tests
 Coagulation test (coagulogramm)

Thrombocytopenia
- decreased level of platelets, produced by bone marrow.
Causes
In rare instances, thrombocytopenia is inherited, or passed from parent to child. More
commonly, certain disorders, conditions and medications cause a low platelet count.
- Alcohol use disorder and alcoholism.
- Autoimmune disease which causes ITP (idiopathic thrombocytopenic purpura). ITP is
sometimes associated with other autoimmune conditions such as lupus.
- Bone marrow diseases, including aplastic anemia, leukemia, certain lymphomas
myelodysplastic syndromes.
- Chemotherapy and radiation therapy.
- Enlarged spleen caused by cirrhosis of the liver .
- Contact with toxic chemicals, including arsenic, benzene and pesticides.
- Some medications (antibiotics), seizures (epilepsy)
- Viruses, such as hepatitis C, CMV, EBV and HIV.

Symptoms
It depends on the count of platelets. Mild reduction of platelets causes no symptoms. By the
sever state it may be detected different types of bleedings.
- red, purple, or brown bruises, which are called purpura
- a rash with small red or purple dots called petechiae
- nosebleeds
- bleeding gums
- bleeding from wounds that lasts for a prolonged period or doesn’t stop on its own
- heavy menstrual bleeding
- Internal (respirarory, gastrointestinal, urinal) bleeding
- Retinal, brain haemorrhages.