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Here is the full analysis of the CBC (Complete Blood Count) report for patient SHUBHANG, dated 17/07, 04:15 AM:
CBC Report Analysis
Patient Details
- Name: SHUBHANG
- SID: 00005
- Report Type: Standard
- Analyzer Flags: FL5, INS_T
Results Table
| Parameter | Value | Status | Normal Range (Adults) | Interpretation |
|---|---|---|---|---|
| WBC | 3.3 × 10³/µL | 🔴 LOW | 4.5 - 11.0 | Leukopenia |
| LYM% | 30.6% | Normal | 20 - 40% | Normal |
| MON% | 6.2% | Normal | 2 - 8% | Normal |
| GRA% (Neut%) | 63.2% | Normal | 50 - 70% | Normal |
| RBC | 5.04 × 10⁶/µL | Normal | 4.5 - 5.9 (M) | Normal |
| HGB | 15.4 g/dL | Normal | 13.5 - 17.5 (M) | Normal |
| HCT | 53.4% | Normal/High-normal | 41 - 53% (M) | Slightly elevated |
| MCV | 106.0 fL | 🔴 HIGH | 80 - 100 fL | Macrocytosis |
| MCH | 30.6 pg | Normal | 27 - 33 pg | Normal |
| MCHC | 28.8 g/dL | 🔴 LOW | 32 - 36 g/dL | Hypochromia |
| RDW | 11.5% | Normal | 11.5 - 14.5% | Normal |
| RDW-SD | 60.0 fL | 🔴 HIGH | 37 - 54 fL | Elevated - anisocytosis |
| PLT | 70 × 10³/µL | 🔴 LOW | 150 - 400 | Thrombocytopenia |
| MPV | 10.8 fL | Normal | 7.5 - 12.5 fL | Normal |
| PCT | 0.076% | 🔴 LOW | 0.19 - 0.39% | Low (mirrors low PLT) |
| PDW | 12.0 fL | Normal | 9 - 17 fL | Normal |
Key Abnormalities
-
Leukopenia (WBC 3.3) - White cell count is below normal. This can be seen in viral infections (especially dengue, COVID-19, EBV), autoimmune conditions, bone marrow suppression, or B12/folate deficiency.
-
Macrocytosis (MCV 106) - Red blood cells are larger than normal. Classic causes include:
- Vitamin B12 deficiency
- Folate deficiency
- Alcohol use
- Liver disease
- Hypothyroidism
- Certain medications (methotrexate, hydroxyurea)
-
Low MCHC (28.8) with elevated MCV - This combination of macrocytic but hypochromic cells is unusual and may suggest a mixed deficiency (B12/folate + iron deficiency together), or it may be a analyzer artifact with the flag INS_T.
-
Thrombocytopenia (PLT 70) - Platelets are significantly low (less than half of lower normal limit). Combined with low WBC, this bicytopenia (two cell lines affected) raises concern for:
- Dengue fever (very common in this clinical picture)
- Megaloblastic anemia (B12/folate deficiency affecting all cell lines)
- Bone marrow failure / aplastic anemia
- Hypersplenism
- Viral infections
-
Elevated RDW-SD (60.0) - Confirms significant variation in red cell sizes (anisocytosis).
Clinical Summary & Recommendations
The pattern of low WBC + low platelets + macrocytosis is a classic presentation of megaloblastic anemia (Vitamin B12 or folate deficiency), where the bone marrow produces abnormal, enlarged cells and fails to keep up with normal blood cell production. However, dengue fever must also be ruled out urgently given the thrombocytopenia and leukopenia.
Suggested follow-up tests:
- Serum Vitamin B12 and Folate levels
- Peripheral blood smear (to look for hypersegmented neutrophils, which confirm megaloblastic anemia)
- Dengue NS1 Antigen + IgM/IgG antibody test (if fever is present)
- Serum ferritin and iron studies (to rule out concurrent iron deficiency)
- LFT (Liver Function Tests) and TSH
- Reticulocyte count
Note: The flag "INS_T" may indicate an instrument calibration or sampling issue - the low MCHC in the presence of a high MCV should be interpreted cautiously and confirmed on a manual smear. Please consult a physician for clinical correlation - this report should not be used for diagnosis in isolation.
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