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Background
RBC count refers to the number of RBCs per unit volume of blood. RBC count elevates either because of reduced plasma volume like hemoconcentration or dehydration or an absolute elevation in RBC production like in renal cell carcinoma (because of the production of erythropoietin) or polycythemia vera. RBC count reduces blood loss or anemia.
Indications/Applications
A standard CBC (complete blood count) includes the RBC count. It is used in the combination of hematocrit and hemoglobin concentration to identify whether the patients have polycythemia, anemia, dehydration or response to the therapy of these conditions. The RBC count normally increases or decreases in combination with hematocrit or hemoglobin.
Clinical Significance:
RBC count with the hemoglobin concentration and hematocrit must be interpreted with the precautions due to the assessment is associated with the plasma volume. Conditions that elevate the plasma volume, like pregnancy it will reduce these values, which do not represent absolute anemia. Conditions which reduce the plasma volume like dehydration will elevates these values which do not represent the absolute polycythemia.
Reference Range
The normal RBC count:
(RBC × 106/μL or RBC × 1012/L [SI units])
The normal range of RBC count:
Adult/Elder:
Female: 4.2 to 5.4 million cells/µL
Male: 4.7 to 6.1 million cells/µL
Children:
Newborns: 4.8 to 7.1 million cells/µL
2 to 8 weeks: 4 to 6 million cells/µL
2 to 6 months: 3.5 to 5.5 million cells/µL
6 months to 1 year: 3.5 to 5.2 million cells/µL
1 to 6 years: 4 to 5.5 million cells/µL
6 to 18 years: 4 to 5.5 million cells/µL
Interpretation
The expected RBC count in infants, children and adults may vary significantly as per the age. RBC counts are high in newborn and low during the infancy until it reaches to the adult level throughout the childhood and adolescence. It is necessary to consult to the doctor to understand what the test results signify as so many factors which can influence the RBC count.
The lifespan of RBC is about 120 days. It must be replaced regularly. Erythropoietin is a hormone which is produced by kidneys and secreted to stimulate bone marrow to produce the RBCs. Health diseases which interfere with the normal function and formation of RBCs may result in an abnormal RBC count.
RBC count is increases in the conditions like:
Primary erythrocytosis: Polycythemia vera
Secondary erythrocytosis: Low level of oxygen (pulmonary fibrosis, COPD, sleep apnea), Renal cell carcinoma, Cardiovascular disease
High altitude
Smokers
Stress
Dehydration and hemoconcentration
Medications like Erythropoietin, Anabolic steroids, Gentamicin, Methyldopa, Testosterone
Other erythropoietin-producing neoplasms
RBC count is reduced in the conditions like:
Hemolysis
Anemia
Vitamin deficiency anemia: vitamin B12 or folate deficiency
Iron deficiency anemia: lack of iron intake
Aplastic anemia: RBC production is stopped by bone morrow
Bone marrow disease associated anemia: leukemia
Sickle cell anemia and Thalassemia: inherited red diseases
Hemolytic anemia: shortened RBC life span because of secondary disease
Hemorrhage
Chronic renal failure
Malnutrition
Overhydration
Pregnancy
Failure of bone marrow production
Certain autoimmune diseases
Toxic chemicals exposure
Chronic alcoholism
Genetic or family history
Certain medications like chemotherapy drugs, chloramphenicol, quinidine, hydantoins
Blood cancers can affect the function and production of RBC. It can lead to abnormal levels of RBC. Each form of blood cancer has a different effect on RBC count. The 3 main types of blood cancers are:
Leukemia: It leads to failure of bone marrow to produce RBCs and platelets
Lymphoma: It affects the WBCs of the immune system
Myeloma: It prevents the normal antibodies production
RBC count can help to differentiate between β- or α-thalassemia trait or iron deficiency along with the MCV. Elevated RBCs and reduced MSC is indicative of thalassemia trait. An MCV/RBC ratio below 13 leads to thalassemia trait and above 13 leads to iron deficiency. This ratio is not sufficient for diagnosis. More precise test must be performed when available.
Collection And Panels
Sample type: Whole blood
Sample collection method: Routine venipuncture
Sample collection container: Ethylenediamine tetra acetic acid (EDTA) tube (Purple or lavender tube) which contains the EDTA potassium salt additive as an anticoagulant
Panels: complete blood count (CBC)
A CBC panel measures RBC, WBC, hemoglobin, platelets, and hematocrit.
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