Complete Blood Count (CBC) - Report Interpretation

ls /home/daytona/workspace/ 2>/dev/null || mkdir -p /home/daytona/workspace

~/cbc_report/generate_cbc_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm, mm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY
from reportlab.pdfbase import pdfmetrics

OUTPUT = "/home/daytona/workspace/cbc_report/CBC_Report_Interpretation.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=2*cm, leftMargin=2*cm,
    topMargin=2*cm, bottomMargin=2*cm,
    title="CBC Report Interpretation",
    author="Orris Medical Assistant"
)

W = A4[0] - 4*cm  # usable width

styles = getSampleStyleSheet()

# Custom styles
title_style = ParagraphStyle(
    "Title", parent=styles["Title"],
    fontSize=22, textColor=colors.HexColor("#1a3a5c"),
    spaceAfter=4, alignment=TA_CENTER, fontName="Helvetica-Bold"
)
subtitle_style = ParagraphStyle(
    "Subtitle", parent=styles["Normal"],
    fontSize=11, textColor=colors.HexColor("#4a6fa5"),
    spaceAfter=14, alignment=TA_CENTER, fontName="Helvetica"
)
h1_style = ParagraphStyle(
    "H1", parent=styles["Heading1"],
    fontSize=13, textColor=colors.white,
    fontName="Helvetica-Bold", spaceAfter=0, spaceBefore=10,
    leftIndent=0
)
h2_style = ParagraphStyle(
    "H2", parent=styles["Heading2"],
    fontSize=11, textColor=colors.HexColor("#1a3a5c"),
    fontName="Helvetica-Bold", spaceAfter=4, spaceBefore=8,
    leftIndent=0
)
body_style = ParagraphStyle(
    "Body", parent=styles["Normal"],
    fontSize=9.5, leading=14, textColor=colors.HexColor("#2c2c2c"),
    spaceAfter=4, alignment=TA_JUSTIFY
)
bullet_style = ParagraphStyle(
    "Bullet", parent=styles["Normal"],
    fontSize=9, leading=13, textColor=colors.HexColor("#2c2c2c"),
    leftIndent=14, bulletIndent=4, spaceAfter=2
)
source_style = ParagraphStyle(
    "Source", parent=styles["Normal"],
    fontSize=7.5, textColor=colors.HexColor("#777777"),
    spaceAfter=2, fontName="Helvetica-Oblique"
)
pearl_style = ParagraphStyle(
    "Pearl", parent=styles["Normal"],
    fontSize=9, leading=13, textColor=colors.HexColor("#1a3a5c"),
    leftIndent=10, spaceAfter=2, fontName="Helvetica-Oblique"
)

def section_header(title):
    """Returns a blue-background section header row."""
    tbl = Table([[Paragraph(title, h1_style)]], colWidths=[W])
    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), colors.HexColor("#1a3a5c")),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING", (0,0), (-1,-1), 8),
        ("RIGHTPADDING", (0,0), (-1,-1), 8),
        ("ROUNDEDCORNERS", [4,4,4,4]),
    ]))
    return tbl

def make_table(headers, rows, col_widths=None):
    data = [[Paragraph(f"<b>{h}</b>", ParagraphStyle("TH", parent=styles["Normal"],
              fontSize=9, textColor=colors.white, fontName="Helvetica-Bold")) for h in headers]]
    for row in rows:
        data.append([Paragraph(str(cell), ParagraphStyle("TD", parent=styles["Normal"],
                     fontSize=8.5, leading=12, textColor=colors.HexColor("#2c2c2c"))) for cell in row])
    tbl = Table(data, colWidths=col_widths or [W/len(headers)]*len(headers), repeatRows=1)
    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,0), colors.HexColor("#2d6a9f")),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [colors.HexColor("#eef4fb"), colors.white]),
        ("GRID", (0,0), (-1,-1), 0.4, colors.HexColor("#b0c4de")),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING", (0,0), (-1,-1), 6),
        ("RIGHTPADDING", (0,0), (-1,-1), 6),
        ("VALIGN", (0,0), (-1,-1), "TOP"),
    ]))
    return tbl

# ─── CONTENT ───────────────────────────────────────────────────────────────

story = []

# Title block
story.append(Spacer(1, 0.3*cm))
story.append(Paragraph("Complete Blood Count (CBC)", title_style))
story.append(Paragraph("A Comprehensive Guide to Report Interpretation", subtitle_style))
story.append(HRFlowable(width=W, thickness=2, color=colors.HexColor("#2d6a9f"), spaceAfter=10))

# Intro
story.append(Paragraph(
    "A CBC is one of the most commonly ordered laboratory test panels. It measures circulating "
    "blood cells — red blood cells (RBCs), white blood cells (WBCs), and platelets — using "
    "automated flow cytometry-based analyzers. The results provide critical diagnostic information "
    "across a wide range of clinical conditions.",
    body_style
))
story.append(Spacer(1, 0.3*cm))

# ── SECTION 1: RBC ────────────────────────────────────────────────────────
story.append(section_header("1.  RED BLOOD CELL (RBC) PARAMETERS"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("Hemoglobin (Hb)", h2_style))
story.append(Paragraph(
    "Primary measure of the blood's oxygen-carrying capacity.",
    body_style
))
hb_table = make_table(
    ["Group", "Normal Range"],
    [["Males", "13.5 – 17.5 g/dL"],
     ["Females", "12.0 – 16.0 g/dL"]],
    col_widths=[W*0.4, W*0.6]
)
story.append(hb_table)
story.append(Spacer(1, 0.2*cm))
story.append(Paragraph("• <b>Low Hb (Anemia):</b> Blood loss, iron/B12/folate deficiency, chronic disease, hemolysis, bone marrow disorders, sickle cell disease.", bullet_style))
story.append(Paragraph("• <b>High Hb (Polycythemia):</b> Polycythemia vera, chronic hypoxia, high altitude, erythropoietin-secreting tumors.", bullet_style))
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("Hematocrit (Hct) / Packed Cell Volume (PCV)", h2_style))
story.append(Paragraph("Percentage of blood volume occupied by RBCs. Roughly 3× the Hb value.", body_style))
hct_table = make_table(
    ["Group", "Normal Range"],
    [["Males", "39 – 49%"],
     ["Females", "35 – 45%"]],
    col_widths=[W*0.4, W*0.6]
)
story.append(hct_table)
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("RBC Count", h2_style))
rbc_table = make_table(
    ["Group", "Normal Range"],
    [["Males", "4.5 – 6.0 × 10⁶/μL"],
     ["Females", "4.0 – 5.4 × 10⁶/μL"]],
    col_widths=[W*0.4, W*0.6]
)
story.append(rbc_table)
story.append(Spacer(1, 0.4*cm))

# ── SECTION 2: RED CELL INDICES ────────────────────────────────────────────
story.append(section_header("2.  RED CELL INDICES  (Key for Anemia Classification)"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph(
    "These calculated values determine the <i>type</i> of anemia and significantly narrow the differential diagnosis.",
    body_style
))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("MCV — Mean Corpuscular Volume  |  Normal: 81–99 fL", h2_style))
story.append(Paragraph("The most important index. Classifies anemia into three types:", body_style))
mcv_table = make_table(
    ["MCV", "Classification", "Common Causes"],
    [["< 80 fL", "Microcytic", "Iron deficiency (most common), thalassemia, sideroblastic anemia, chronic disease"],
     ["80–100 fL", "Normocytic", "Acute blood loss, hemolytic anemia, renal insufficiency, anemia of chronic disease, mixed deficiency"],
     ["> 100 fL", "Macrocytic", "Vit B12 deficiency, folate deficiency, alcohol, liver disease, hypothyroidism, hydroxyurea, methotrexate"]],
    col_widths=[W*0.15, W*0.2, W*0.65]
)
story.append(mcv_table)
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("MCH — Mean Corpuscular Hemoglobin  |  Normal: 30–34 pg", h2_style))
story.append(Paragraph("Amount of Hb in an average RBC. Trends with MCV.", body_style))
story.append(Paragraph("• <b>Low MCH (Hypochromic):</b> Iron deficiency, thalassemia.", bullet_style))
story.append(Paragraph("• <b>High MCH (Hyperchromic):</b> Hereditary spherocytosis.", bullet_style))
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("MCHC — Mean Corpuscular Hb Concentration  |  Normal: 30–36 g/dL", h2_style))
story.append(Paragraph("Hb concentration per unit of RBC volume.", body_style))
story.append(Paragraph("• <b>Low MCHC:</b> Iron deficiency, thalassemia.", bullet_style))
story.append(Paragraph("• <b>High MCHC:</b> Hereditary spherocytosis (key diagnostic clue).", bullet_style))
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("RDW — RBC Distribution Width  |  Normal: 12–15% (CV) / 37–47 fL (SD)", h2_style))
story.append(Paragraph("Measures variation in RBC size (anisocytosis). Useful for distinguishing anemias:", body_style))
story.append(Paragraph("• <b>High RDW + Low MCV:</b> Iron deficiency anemia (thalassemia trait typically has normal RDW).", bullet_style))
story.append(Paragraph("• <b>High RDW + High MCV:</b> B12 or folate deficiency.", bullet_style))
story.append(Spacer(1, 0.4*cm))

# ── SECTION 3: WBC ────────────────────────────────────────────────────────
story.append(section_header("3.  WHITE BLOOD CELL (WBC) COUNT & DIFFERENTIAL"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("Total WBC Count  |  Normal: 4,000 – 10,000 cells/mm³", h2_style))
story.append(Paragraph("• <b>Leukocytosis (WBC > 10,000/mm³):</b> Infection, inflammation, burns, trauma, pregnancy, steroids. If WBC > 100,000/mm³ (hyperleukocytosis), strongly suspect leukemia.", bullet_style))
story.append(Paragraph("• <b>Leukopenia (WBC < 4,000/mm³):</b> Chemotherapy/radiation, aplastic anemia, HIV/AIDS, autoimmune disease, antipsychotics, antiepileptics.", bullet_style))
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("5-Part WBC Differential", h2_style))
diff_table = make_table(
    ["Cell Type", "Normal %", "Elevated (Causes)", "Decreased (Causes)"],
    [["Neutrophils", "50–70%", "Bacterial infections, trauma, leukemia, steroids, rheumatic disease", "Overwhelming infection, viral illness, drug reactions, aplastic anemia, autoimmune"],
     ["Lymphocytes", "20–40%", "Viral infections (EBV, CMV), CLL, pertussis", "HIV/immunodeficiency, steroids, chemotherapy, irradiation"],
     ["Monocytes", "2–8%", "TB, SBE, sarcoidosis, IBD, recovering marrow", "Steroid therapy, hairy cell leukemia"],
     ["Eosinophils", "1–4%", "Parasites, allergic diseases, asthma, drug reactions, Hodgkin's", "Acute stress, Cushing's syndrome, corticosteroids"],
     ["Basophils", "0–1%", "CML, allergic reactions, polycythemia vera", "Corticosteroid use, acute infection, hyperthyroidism"]],
    col_widths=[W*0.14, W*0.1, W*0.38, W*0.38]
)
story.append(diff_table)
story.append(Spacer(1, 0.2*cm))
story.append(Paragraph(
    "⚑  'Left shift' = increased band cells (immature neutrophils) — indicates active bacterial infection or bone marrow stress.",
    pearl_style
))
story.append(Paragraph(
    "⚑  Absolute Neutrophil Count (ANC) < 1,500/mm³ = neutropenia (significant infection risk).",
    pearl_style
))
story.append(Spacer(1, 0.4*cm))

# ── SECTION 4: PLATELETS ──────────────────────────────────────────────────
story.append(section_header("4.  PLATELETS"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("Platelet Count  |  Normal: 150,000 – 400,000/μL", h2_style))

plt_table = make_table(
    ["Range", "Severity", "Clinical Implication"],
    [["50,000–150,000/μL", "Mild thrombocytopenia", "Bleeding uncommon unless trauma or surgery"],
     ["10,000–50,000/μL", "Moderate", "Bleeding risk with trauma; consider transfusion pre-procedure"],
     ["< 10,000–20,000/μL", "Severe", "Risk of spontaneous major bleeding; urgent management"]],
    col_widths=[W*0.28, W*0.24, W*0.48]
)
story.append(plt_table)
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("Causes of Thrombocytopenia", h2_style))
cause_table = make_table(
    ["Category", "Causes"],
    [["Decreased production", "Bone marrow suppression, leukemia, aplastic anemia, B12/folate deficiency, chemotherapy, viral infections"],
     ["Increased destruction", "ITP, DIC, TTP/HUS, drug-induced (heparin-HIT), SLE"],
     ["Sequestration", "Hypersplenism (liver disease, portal hypertension)"]],
    col_widths=[W*0.28, W*0.72]
)
story.append(cause_table)
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("Thrombocytosis (Platelets > 400,000/μL)", h2_style))
story.append(Paragraph("• <b>Reactive:</b> Iron deficiency, infection, inflammation, post-splenectomy.", bullet_style))
story.append(Paragraph("• <b>Primary (Essential thrombocythemia):</b> Myeloproliferative disorder — requires further workup.", bullet_style))
story.append(Spacer(1, 0.3*cm))

story.append(Paragraph("Mean Platelet Volume (MPV)", h2_style))
story.append(Paragraph("• <b>High MPV:</b> Young, active platelets — seen in ITP (compensatory production).", bullet_style))
story.append(Paragraph("• <b>Low MPV:</b> Wiskott-Aldrich syndrome, bone marrow failure.", bullet_style))
story.append(Spacer(1, 0.4*cm))

# ── SECTION 5: RETICULOCYTE ───────────────────────────────────────────────
story.append(section_header("5.  RETICULOCYTE COUNT"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("Reticulocytes are immature RBCs released from the bone marrow. This parameter separates hypoproliferative from hyperproliferative anemias.", body_style))

retic_table = make_table(
    ["Parameter", "Normal Range"],
    [["Reticulocyte %", "0.5 – 1.5%"],
     ["Absolute reticulocyte count", "20,000 – 100,000/μL"],
     ["Reticulocyte Production Index (RPI)", "0.5 – 2.5"]],
    col_widths=[W*0.5, W*0.5]
)
story.append(retic_table)
story.append(Spacer(1, 0.2*cm))
story.append(Paragraph("• <b>RPI < 2 in anemia:</b> Bone marrow not responding (hypoproliferative) — iron/B12/folate deficiency, aplastic anemia, anemia of chronic disease.", bullet_style))
story.append(Paragraph("• <b>RPI > 3 in anemia:</b> Bone marrow responding appropriately (hyperproliferative) — hemolysis or acute blood loss.", bullet_style))
story.append(Spacer(1, 0.4*cm))

# ── SECTION 6: BLOOD SMEAR ───────────────────────────────────────────────
story.append(section_header("6.  PERIPHERAL BLOOD SMEAR FINDINGS"))
story.append(Spacer(1, 0.2*cm))
story.append(Paragraph("Indicated when automated analyzers flag abnormal results. Key morphological findings:", body_style))

smear_table = make_table(
    ["Finding", "Significance"],
    [["Target cells (codocytes)", "Thalassemia, liver disease, HbC disease"],
     ["Schistocytes (fragmented RBCs)", "TTP, DIC, mechanical hemolysis (prosthetic valves)"],
     ["Howell-Jolly bodies", "Functional or anatomic asplenia"],
     ["Hypersegmented neutrophils", "Vitamin B12 or folate deficiency (megaloblastic anemia)"],
     ["Spherocytes", "Hereditary spherocytosis, autoimmune hemolytic anemia"],
     ["Sickle cells", "Sickle cell disease"],
     ["Tear-drop cells (dacrocytes)", "Myelofibrosis"],
     ["Large vacuoles in neutrophils", "Chediak-Higashi syndrome"],
     ["Small platelets", "Wiskott-Aldrich syndrome"]],
    col_widths=[W*0.38, W*0.62]
)
story.append(smear_table)
story.append(Spacer(1, 0.4*cm))

# ── SECTION 7: QUICK SUMMARY ─────────────────────────────────────────────
story.append(section_header("7.  QUICK INTERPRETATION SUMMARY"))
story.append(Spacer(1, 0.2*cm))

summary_table = make_table(
    ["Parameter", "If LOW", "If HIGH"],
    [["Hb / Hct", "Anemia", "Polycythemia"],
     ["MCV", "Microcytic anemia (iron, thalassemia)", "Macrocytic anemia (B12, folate, alcohol)"],
     ["RDW", "(rarely significant)", "Anisocytosis — iron deficiency, mixed deficiency"],
     ["WBC (Total)", "Leukopenia (viral, drugs, immunosuppression)", "Leukocytosis (infection, inflammation, leukemia)"],
     ["Neutrophils", "Neutropenia — bacterial infection risk", "Neutrophilia — bacterial infection, steroids"],
     ["Lymphocytes", "Immunodeficiency, HIV, steroids", "Viral infection, CLL"],
     ["Eosinophils", "Corticosteroids, acute stress", "Parasites, allergy, asthma"],
     ["Platelets", "Thrombocytopenia — bleeding risk", "Thrombocytosis (reactive or myeloproliferative)"]],
    col_widths=[W*0.2, W*0.4, W*0.4]
)
story.append(summary_table)
story.append(Spacer(1, 0.5*cm))

# ── SOURCES ──────────────────────────────────────────────────────────────
story.append(HRFlowable(width=W, thickness=0.8, color=colors.HexColor("#b0c4de"), spaceAfter=6))
story.append(Paragraph("<b>Sources</b>", ParagraphStyle("SrcHead", parent=styles["Normal"], fontSize=8.5, fontName="Helvetica-Bold", textColor=colors.HexColor("#444444"))))
story.append(Paragraph("Histology: A Text and Atlas with Correlated Cell and Molecular Biology (Pawlina), pp. 728–730", source_style))
story.append(Paragraph("Textbook of Family Medicine, 9th Edition, p. 227", source_style))
story.append(Paragraph("Goldman-Cecil Medicine, International Edition — Tables 144-2, 144-3", source_style))
story.append(Paragraph("Henry's Clinical Diagnosis and Management by Laboratory Methods", source_style))

# ── BUILD ─────────────────────────────────────────────────────────────────
doc.build(story)
print(f"PDF saved to: {OUTPUT}")

cd /home/daytona/workspace/cbc_report && python generate_cbc_pdf.py 2>&1