CBC (Complete Blood Picture) Report - Nighat Parveen

Here's a breakdown of the report, test by test, compared to the normal reference ranges given on the slip.

Overall picture: normal counts, but red cells are small and pale (mild microcytic, hypochromic pattern)

Test	Result	Normal (Female)	Interpretation
Hemoglobin	12.5 g/dL	12.0 - 16.0	Normal, but at the lower end
RBC count	4.93 x10⁶/µL	4.2 - 5.4	Normal
PCV/HCT	37.69%	36 - 46	Normal
MCV	76.4 fL	80 - 100	Low - cells are smaller than average (microcytic)
MCH	25.3 pg	26 - 34	Low - each cell carries less hemoglobin (hypochromic)
MCHC	33.2 g/dL	31 - 37	Normal
TLC (total WBC)	5600 /µL	4500 - 11000	Normal
Platelet count	231,000 /µL	140,000 - 440,000	Normal
ESR	Not performed	-	Blank on report
Retic. count	Not performed	-	Blank on report

Differential Leucocyte Count (DLC) - breakdown of the white cells:

Cell type	Result	Normal	Status
Neutrophils	57%	54-62	Normal
Lymphocytes	34%	25-33	Marginally above range (by 1 point - not clinically meaningful on its own)
Monocytes	5%	3-7	Normal
Eosinophils	4%	1-6	Normal
Basophils	0%	0-0.75	Normal

What this means in plain terms

Hemoglobin (12.5), RBC count, and hematocrit are all technically within the normal range, so this is not a frank, established anemia.
However, MCV and MCH are both reduced, meaning the red blood cells being produced are smaller than normal and contain less hemoglobin per cell than they should - a microcytic, hypochromic pattern. As Harrison's Principles of Internal Medicine explains, "anemia is grouped by MCV, with those with smaller MCV called microcytic... microcytic anemia is due to any process that [impairs hemoglobin synthesis]" (Harrison's Principles of Internal Medicine, 22nd Ed).
This combination (normal-ish hemoglobin but low MCV/MCH) often represents an early or mild stage of iron deficiency - low MCV/MCH typically appear before hemoglobin actually drops below the normal cutoff. The other classic cause of this exact pattern, especially if it's long-standing or if there's a family history, is a thalassemia trait (minor).
White cell count, platelet count, and the differential are essentially unremarkable - no signs of infection, inflammation, or a bleeding/clotting disorder from this report.
ESR and reticulocyte count were left blank, meaning they were not run for this sample (not "zero" - just not tested).

What I'd suggest next

This report alone can't distinguish iron deficiency from a thalassemia trait, since both cause a microcytic/hypochromic pattern. To clarify, the treating doctor would typically want:

Iron studies - serum iron, ferritin, TIBC/transferrin saturation (low ferritin points to iron deficiency)
Peripheral blood smear review (looking for target cells, anisocytosis, etc.)
If iron studies are normal, hemoglobin electrophoresis / HbA2 level to check for thalassemia trait

This is general lab interpretation, not a diagnosis - the patient's doctor should correlate this with her symptoms, history (e.g., diet, menstrual history if applicable, family history of anemia), and any further tests before drawing conclusions.

A quick check of recent systematic reviews on iron deficiency anemia diagnosis didn't surface anything that changes this interpretation - the MCV/MCH-based approach remains standard.

This is a shared conversation. Sign in to Orris to start your own chat.