Decoding blood tests in children
Complete blood count can be called the most common clinical analysis, which is passed in childhood and adulthood. Its indicators help to identify violations in the body and diagnose many diseases.
Norm
Before finding out whether the indicators of a children's blood test are normal, you should find out exactly which indicators are determined and what they are responsible for.
In general, blood tests determine:
- Erythrocytes. So called red cells, the most important function of which is the binding and transport of oxygen and carbon dioxide. In the hematology analyzer, erythrocyte parameters such as the width of the distribution (showing the difference between the largest and smallest cells) and the average volume are additionally determined. As well as an indicator of the concentration of hemoglobin in the erythrocyte, hematologists need these parameters to diagnose various types of anemia.
- Hemoglobin. It is a protein contained in red blood cells that binds oxygen as well as carbon dioxide. In its structure emit heme containing iron. It is due to the presence of heme in red blood cells and blood red color. The study determines how many grams of a given protein is in a liter of blood.
- Color indicator. A parameter calculated using a special formula that shows how much hemoglobin is contained in an erythrocyte.
- Hematocrit. This indicator determines how much of the whole blood is the cell, that is, it indicates blood density.
- Reticulocytes. So called young red blood cells, the number of which is determined in ppm.
- Leukocytes. These are white blood cells that help protect the child’s body from various infections.
- Leukocyte formula. This is the name given to the percentage of leukocyte species present in the child’s body.
- Platelets. Such blood cells are important for stopping bleeding in the event of vascular damage. These cells are also called blood plates for their shape.
- ESR. This parameter shows how quickly the blood cells settle, separating from the plasma.
Leukocyte formula includes:
- Neutrophils (cells containing granules for the fight against bacteria), which in the normal analysis are segmented (more mature neutrophils, presented in greater numbers) and stab (nuclear forms). Such forms of neutrophils as young (metamyelocytes) and myelocytes are also isolated. These forms are immature and appear in the blood test for diseases.
- The second group of leukocytes are eosinophils, which also include granules, but do not react to bacteria, but to allergens.
- In a small amount in the blood are basophils, which also have granules. In the hematology analyzer, the GRAN parameter is determined, taking into account all the granular forms of leukocytes (basophils, eosinophils and neutrophils).
- A large group of leukocytes are lymphocytes responsible for immune reactions. They respond primarily to viral infections.
- Cells, which are called monocytes, absorb bacteria, dead cells and other particles that need to be removed from the body.
- And another type of leukocytes, presented in very small quantities, is called plasma cells. They form antibodies.
The normal values for each indicator differ at different ages of the child:
Age | Erythrocytes (1012 / L) | Hemoglobin (g / l) | Color indicator | Hematocrit (%) | Reticulocytes (‰) | Leukocytes (109 / l) | Platelets (109 / l) | ESR (mm / h) |
1 day | 5-7 | 180-240 | 1,2 | 56 | 10-40 | 10-30 | 180-490 | 2-4 |
5 days | 4,5-6 | 160-200 | 1,27 | 53 | 0-20 | 9-15 | 180-400 | 4-8 |
10 days | 4,5-5,5 | 160-190 | 1,2 | 49 | 0-15 | 8,5-14 | 180-400 | 4-10 |
1 month | 4-5 | 120-160 | 1,1 | 45 | 5-13 | 8-12 | 180-400 | 4-10 |
1 year | 4-4,5 | 110-130 | 0,8 | 35 | 5-12 | 7-11 | 160-390 | 4-12 |
5 years | 4-4,5 | 110-140 | 0,9 | 37 | 3-10 | 6-10 | 160-390 | 4-12 |
10 years | 4-4,5 | 120-140 | 0,95 | 39 | 3-10 | 6-10 | 160-390 | 4-12 |
15 years | 4-5,5 | 120-140 | 1 | 47 | 4-9 | 5-9 | 160-390 | 4-12 |
Normal leukocyte formula:
1 day | 5 days | 10 days | 1 month | 1 year | 5 years | 10 years | 15 years | |
Band neutrophils | 5-12 | 1-5 | 1-4 | 1-5 | 1-5 | 1-4 | 1-4 | 1-4 |
Segmented neutrophils | 50-70 | 35-55 | 27-47 | 17-30 | 20-35 | 35-55 | 40-60 | 40-60 |
Eosinophils | 1-4 | 1-4 | 1-5 | 1-5 | 1-4 | 1-4 | 1-4 | 1-4 |
Basophils | 0-1 | 0-1 | 0-1 | 0-1 | 0-1 | 0-1 | 0-1 | 0-1 |
Lymphocytes | 16-32 | 30-50 | 40-60 | 45-60 | 45-65 | 35-55 | 30-45 | 30-45 |
Monocytes | 4-10 | 6-14 | 6-14 | 5-12 | 4-10 | 4-6 | 4-6 | 3-7 |
Plasma cells | 0 | 0,25-0,5 | 0,25-0,5 | 0,25-0,5 | 0,25-0,5 | 0,25-0,5 | 0,25-0,5 | 0,25-0,5 |
Causes of deviations
Each indicator of the complete blood count is analyzed separately.
Red blood cells
When the number of red blood cells is reduced, anemia is diagnosed. Its causes may be blood loss from injuries, nutrition, fermentopathy, leukemia, or red blood cell death due to hemolysis, poor in proteins and vitamins.
An increase in the number of red blood cells may indicate dehydration, erythremia, stenosis of the renal artery, as well as diseases that cause heart or respiratory failure.
Hemoglobin
With a low level of hemoglobin, anemia is also diagnosed, which can be caused both by malnutrition and blood loss or congenital blood diseases.
If, on the contrary, hemoglobin is elevated, the causes of this condition can be dehydration, kidney, lung or heart disease, affecting the blood flow, as well as erythremia.
Change color index
The parameter will be increased with erythremia, heart failure, dehydration, respiratory failure.
Its decrease is observed with anemia and renal failure.
White blood cells
An increase in the number of white blood cells (leukocytosis) may be physiological. Such leukocytosis occurs within a few hours after eating, as well as some time after exercise (in babies after a long cry) or emotional overload.
Abnormal increase in leukocytes occurs when:
- Inflammatory diseases;
- Oncoprocesses, including leukemia;
- Injuries and burns if a large area of the body is damaged;
- Exacerbation of rheumatism;
- Postoperative recovery.
The decrease in the number of leukocytes (it is called leukopenia) is noted when:
- Infectious and viral diseases;
- Systemic lupus erythematosus and rheumatoid arthritis;
- Some forms of leukemia;
- The use of steroid drugs and cytostatics in the treatment of tumors;
- Hypovitaminosis;
- Radiation Disease.
Leukocyte formula
Type of leukocytes | What the increase indicates | What a drop indicates |
Neutrophils |
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|
Eosinophils |
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Monocytes |
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Basophils |
| - |
Lymphocytes |
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Separately, it should be noted the distribution among the forms of neutrophils:
- If more stab neutrophils are detected in a child’s blood, as well as myelocytes and young neutrophils are detected, the leukocyte formula is interpreted as a “left shift”. It is characteristic of inflammatory and infectious diseases, acute blood loss, and intoxication.
- If the number of segmented neutrophils increases, this formula is called the "right shift." Such an analysis may suggest a lack of folic acid or vitamin B12.
Platelets
The number of platelets will exceed the norm if the child has a spleen removed or has undergone any other operation, as well as during physical exhaustion, erythremia, cancer, anemia, and inflammatory processes.
If the platelets are less than normal, this may indicate hemophilia, heart failure, various infections, or aplastic anemia. Also, the number of platelets may decrease after blood transfusions, with DIC and hemolytic disease in the newborn, in premature babies and after taking certain medications.
ESR
The rate decreases very rarely, but its increase is often evidence of an inflammatory process in the body.
Opinion E. Komarovsky about blood test
A well-known pediatrician calls the blood test an ideal test, since it can be quickly and cheaply provided answers to questions regarding diagnosis. He considers the qualitative and quantitative determination of the state of blood cells to be very informative.
What to consider?
First of all, moms and dads need to remember that the indicators of blood analysis in a child will differ from the norms established for adults. And if you were given a form with the results, the norms that usually indicate on such a form apply to adults. So you should not panic when you notice a large deviation in numbers.
The results of the analysis may differ from the time of day and depend on the nutrition of the child, so it is traditionally recommended to take an analysis in the morning on an empty stomach, but this is not a mandatory measure, but rather a wish.
You should also be aware that it is not always in the analysis of blood that all of the indicators described above are determined. Sometimes there is no laboratory doctor (without him, the leukocyte formula is not determined), sometimes there is no equipment or reagents, sometimes the laboratory is overloaded. Mandatory indicators that always determine are the amount of hemoglobin, the number of leukocytes and ESR.