28 Sept 2023 • You just read your patient's CBC report📂

Platelet count: 28000/μL

28000?!🤯

Your patient is currently being treated for dengue and his family is panicking and insisting on administering a platelet transfusion.

Do you think the patient should be given a platelet transfusion? Let's find out!🧐

Dr. Mahadev Desai, in the session 'Interpretation of CBC and Newer Parameters', shines light on the conventional and newer parameters to understand a patient's blood profile and beyond.

It is important to consider clinical context and patient history when interpreting the CBC and other parameters.

'Never act upon a single abnormal reading without further investigation or confirmation'✅

Here are a few clinical pearls from the session:

• Hemoglobin🩸: According to WHO, Anemia is defined by a Hb <12g/dL, while Hb>17g/dL may be seen in Polycythemia and cases of hemoconcentration (e.g Dehydration)

How about the Hb levels in a patient with Emphysema? Will it be within the normal range?

No, Hb will be elevated as a result of secondary polycythemia.

• RBC count and RBC indices💉

When it comes to Anemia, RBC indices like MCV and RDW can be used along with the RBC count to draw a comparison between Iron - deficiency Anemia, Thalassemia and Vitamin B12 deficiency.

Mentzer Index which is measured MCV/RBC, can help differentiate between Thalassemia (<13) and IDA (>13).

One of the newer and sophisticated parameters, Ratio of % microcytic RBCs and % hypochromic RBCs is markedly decreased in IDA and increased in Thalassemia.

• ESR may be inaccurate for age, so make sure to calculate age - adjusted ESR (Age/2), for instance for a 50 y/o patient, the upper limit of the normal range is 25 mm/hour.

• Don't forget to look at the PBS🔬, which can give a lot of clues to various blood disorders.

• IPF before platelet transfusions

In patients with dengue who have reported thrombocytopenia, make sure to check the Immature Platelet Fraction (IPF), another one of the newer parameters, before considering platelet transfusions.

An IPF greater than 10% is indicative of platelet recovery within 24 - 48 hours. Hence, platelet transfusions can be avoided.✅

And there's much more to learn from Dr. Desai! 🤗

Click here to watch the replay of Interpretation of CBC and Newer Parameters by Dr. Mahadev Desai right here on Medflix 💛