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🔬 Laboratory Report — Ruhi Prajapati | Female, 5 Years | 19 May 2026
Referring Doctor: Dr. Rinkalbhai Gajjar | Hospital: Balmukund Hospital, Ranip | Lab: GL SAWPL, Ahmedabad
📋 Complete Blood Count (CBC) — Summary & Interpretation
🔴 Red Blood Cell (RBC) Parameters
| Test | Result | Reference | Flag | Meaning |
|---|---|---|---|---|
| Hemoglobin | 11.3 g/dL | 11.4–14.3 | ⬇️ LOW | Slightly below normal — mild anemia |
| RBC Count | 5.32 million/cmm | 4–5.1 | ⬆️ HIGH | More RBCs than normal (body compensating) |
| Hematocrit (PCV) | 33.0% | 34–42% | ⬇️ LOW | Less total red cell volume |
| MCV | 62.1 fL | 77.2–89.5 | ⬇️ LOW | Red cells are smaller than normal (microcytic) |
| MCH | 21.2 pg | 27–29.6 | ⬇️ LOW | Each cell carries less hemoglobin (hypochromic) |
| MCHC | 34.2 g/dL | 34–35.6 | ✅ Normal | Concentration of Hb within cells is okay |
| RDW-CV | 17.70% | 11.3–13.4 | ⬆️ HIGH | Red cells vary a lot in size (anisocytosis) |
What this means: The combination of low Hb, low MCV (small cells), low MCH (pale cells), high RBC count, and high RDW strongly points to iron deficiency anemia — or possibly beta-thalassemia trait. The high RBC count with low Hb is a classic feature of thalassemia trait, where the body makes many small cells but each carries little hemoglobin.
⚪ White Blood Cells (WBC) — Immune Cells
| Test | Result | Reference | Flag | Meaning |
|---|---|---|---|---|
| Total WBC | 11,300 /cmm | 4,400–12,900 | ✅ Normal | Within range |
| Neutrophils | 49.5% / 5,594 /cmm | Within range | ✅ Normal | Main infection fighters — normal |
| Lymphocytes | 41.2% / 4,656 /cmm | Within range | ✅ Normal (abs count slightly high) | Slightly elevated absolute count — common in children |
| Eosinophils | 1.6% / 181 /cmm | 1–4% | ✅ Normal | Allergy/parasite fighters — normal |
| Monocytes | 7.7% / 870 /cmm | Within range | ✅ Normal | |
| Basophils | 0% | 0–1% | ✅ Normal |
What this means: No active bacterial or viral infection based on WBC differential.
🟡 Platelets
| Test | Result | Reference | Flag | Meaning |
|---|---|---|---|---|
| Platelet Count | 725,000 /cmm | 200,000–490,000 | ⬆️ HIGH | Thrombocytosis — elevated platelets |
| MPV (Mean Platelet Volume) | 6.90 fL | 7.5–10.3 | ⬇️ Low | Platelets are smaller than normal |
What this means: High platelet count (thrombocytosis) is seen in:
- Iron deficiency anemia (very commonly causes reactive thrombocytosis)
- Infections or inflammation
- Less commonly, thalassemia
This is most likely reactive thrombocytosis due to the iron deficiency state.
🔬 Peripheral Smear (Blood Film Examination)
| Finding | Meaning |
|---|---|
| Hypochromic (+) | Red cells are pale — less hemoglobin inside |
| Microcytic (+) | Red cells are smaller than normal |
| Anisopoikilocytosis (+) | Variation in both size (aniso) and shape (poikilocytosis) of RBCs |
| Few Elliptocytes | Some oval-shaped red cells — can be seen in iron deficiency or hereditary elliptocytosis |
| WBC morphology: Normal | No blast cells, no toxic changes — reassuring |
| Thrombocytosis | Confirms high platelet count seen on automated count |
| Malarial parasite: NOT detected | Negative for malaria — good |
🧪 ESR (Erythrocyte Sedimentation Rate)
| Test | Result | Reference | Flag | Meaning |
|---|---|---|---|---|
| ESR | 28 mm/hr | 0–15 mm/hr | ⬆️ HIGH | Elevated — indicates inflammation or anemia |
What this means: A raised ESR in this context is expected with anemia (anemia itself elevates ESR). It can also reflect mild background inflammation.
🧫 Biochemistry (Page 2)
| Test | Result | Reference | Flag | Meaning |
|---|---|---|---|---|
| CRP (C-Reactive Protein) | 1.3 mg/L | < 7.0 mg/L | ✅ Normal | No significant active inflammation or acute infection |
What this means: CRP is a very sensitive marker of acute inflammation. A value of 1.3 mg/L is completely normal, confirming there is no acute bacterial infection or active inflammatory process right now.
Awaited test: Serum Total IgE — this has been ordered but results are not yet available. IgE is measured to screen for allergies or parasitic infections (e.g., worm infestations), which can sometimes cause anemia too.
🩺 Overall Clinical Picture — What Does This All Mean?
The pattern across all findings points to:
⚠️ Microcytic Hypochromic Anemia — Most Likely Iron Deficiency Anemia
All the classic features are present:
- Low Hb, low MCV, low MCH
- High RDW (size variation)
- Hypochromic microcytic cells on smear
- Reactive thrombocytosis (high platelets)
- Raised ESR (partly due to anemia itself)
- Normal CRP (no acute infection driving this)
🔍 Thalassemia Trait Cannot Be Ruled Out
The high RBC count (5.32 million) with low Hb is a specific clue that thalassemia trait (especially beta-thalassemia minor) may be co-existing or the primary cause. To distinguish:
- Iron deficiency: RBC count usually low or normal
- Thalassemia trait: RBC count is often high (as seen here)
A Mentzer Index = MCV ÷ RBC = 62.1 ÷ 5.32 = ~11.7 → Values <13 favor thalassemia trait; >13 favor iron deficiency. Here it is borderline.
📌 Recommended Next Steps (for Dr. Gajjar to consider)
- Serum Ferritin + Serum Iron + TIBC — to confirm iron deficiency
- Hemoglobin electrophoresis (HPLC) — to rule out beta-thalassemia trait
- Total IgE (already ordered) — to screen for allergic/parasitic cause
- If iron deficiency confirmed → oral iron supplementation + dietary advice (green leafy vegetables, meat, vitamin C with meals)
⚠️ Disclaimer: This is an educational explanation of the report. All medical decisions — including diagnosis and treatment — must be made by Ruhi's treating physician, Dr. Rinkalbhai Gajjar, based on her full clinical history and examination.
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