Normal Reference Value of Blood Cell Count, Red, white and ...

Normal Reference Value of Blood Cell Count, Red, white and Platelet 

of Khartoum North Area 

Malik Mohamed Osman 

Khartoum North Teaching Hospital 

ABSTRACT 

Background: This study was conducted to identify the normal reference values of blood, the red 

cells, the white cells and platelets counts in Khartoum North Area. The total number of samples 

was 400 (200 females and 200 males). Methods: EDTA anti coagulant venous blood sample was 

collected from each subject. The complete blood count (CBC) was measured by using automated 

hematological analyzer (Sysmex kx-21) and blood film was done. Analysis was done in central 

lab of Khartoum North Hospital. Healthy person’s samples were collected from Sudanese 

population as control. This was dependent on the range of standard normal count of RBCs, 

WBCs and Platelet + normal Hb i.e., subjects with symptoms with high or low readings were 

excluded. The age range of the subjects was from 16 to 60 years. A questionnaire was filled by 

each subject. Investigations of the renal functions and urine general were performed in some of 

the persons to exclude any abnormality that indicates exclusion of the person. Results: The 

results showed that the WBCs count was 4.2-6.4× 10³/µL for females and 4.0-6.2× 10³/µL for 

males, RBCs count 4.2-5.0 10³/µL for females and 4.6-5.6 × 10³/µL for males. Platelet count 

(205.4-350.2) ×10³/µL for females and (179.0-324.6) ×10³/µL for males. That means, platelet 

count is higher in female than in male. Literature review from different countries was reviewed. 

Also the causes of elevated and reduced of total WBCs, RBCs and Platelet count were reviewed. 

Keywords: Normal reference values, Red cells, White cells, Platelets counts 

INTRODUCTION 

Normal range of: 

The Red Blood Cells 

The red cell is 8 µm in diameter, flexible 

and biconcave disc. Life span is 120 days, 

floating in the plasma with other cells (white 

blood and platelet) to form blood. (1) Red 

cells, white blood cells (WBCs), and platelet 

constitutes approximately 45% of the blood 

volume. (2) The main function of red cell is 

to carry oxygen to the tissues and return 

carbon dioxide from tissues to the lungs. In 

order to achieve this gases exchange they 

contain the specialized protein haemoglobin 

(Hb) (1) 

Definition: Red cell count (RBC): the 

number of red blood cell in a volume of 

blood. (1) 

100 

2013 Al Neelain Medical Journal vol.3No. 8 ISSN 1858-627

Normal range of Red cells count in 

British population: 

Man 5.0±0.5×10 6 /µL. Women 4.3± 

0.5×10 6 /µL 

Hb: Man 15.0±1.5 gm/d L. Women 

13.5±2 gm/d L (3) 

Normal range varies slightly between 

laboratory but is generally between (4.2- 

5.9) million cells/cm.sq. (4) High red blood 

cell count have a variety of causes, some of 

which can be quite serious, including heart, 

lung, and kidney disease. Polycythemia 

Vera, a bone marrow disorder, is another 

cause. (5) 

White blood cell 

White Blood Cells are an important part of 

the body’s defence system. But too much is 

not always good. (11) 

White Blood Cells definition: 

Are mainly concerned with protecting the 

body against invasion by micro organisms. (2) 

White blood cells, also called leukocytes, 

help the body fight infection. (12) . 

White Blood Cell Count and CBC 

Blood circulate through the body providing 

nutrients and oxygen to all the cells in the 

body and similarly remove the waste 

products. When you go in for a complete 

physical test, you will probably undergo a 

series of tests to evaluate the composition 

and concentration of all the cellular 

components of blood. This test is known as 

the Complete Blood Count (CBC) and 

consists of tests to evaluate Red Blood Cell 

(RBC) count, White Blood Cell (WBC) 

count, the platelet count, and measurement 

of hemoglobin, mean red cell volume and a 

few more. (11) The Complete Blood Count 

helps evaluate the blood and the bone 

101 

marrow and is usually performed to ensure 

oxygen carrying capacity of the blood, 

identify infections, diagnose anemia and 

leukemia and also gauge the effect of 

chemotherapy and radiation therapy on 

blood production cells. (11) 

Neutrophils: 50 – 70% 

Lymphocytes: 25 – 35% 

Basophils: 0.4 – 1% 

Eosinophils: 1 – 3% 

Monocytes: 4 – 6% 

A high blood count (above 30000 cells per 

micro-liter) indicates is not a specific 

disease by itself but indicates infection, 

systemic illness, inflammation, allergy, 

leukemia and tissue injury caused due to 

burns. The count of white blood cells also 

decreases when certain medicines cause 

marrow failure. A severely low white blood 

count i.e. a count less than 2500 cells per 

micro-liter is a cause for a critical alert and 

(11) 

poses a high risk of sepsis. 

The platelets: Definition of platelet: are 

tiny cells which play essential part in the 

very complex process of blood clotting. A 

blood clot a plug” it prevents excessive loss 

of blood. (1) 

The Platelet are fragments are 

fragments of the of the cytoplasm of the 

megakryocyte; hence they are non-nucleated 

and formed chiefly in the bone marrow . (19) 

Platelet lives only about 10 days, your body 

continually renews your platelet supply by 

producing new platelets in your bone 

marrow. (20) 

Platelets made in the bone marrow circulate 

for approximately 10 days before removal 

from circulate. (21) 


High Platelets is a condition in which Counts by automated haematology 

the blood contains more platelets than analyzer in different countries 

normal. Platelets are small blood cell 

fragments that assist in blood clotting. In a Erythrocyte reference values in 

healthy person, there are usually 150,000 to 

Emirati people was found as 

450,000 platelets per micro liter of blood. A 

follows: 

high platelet count can be identified through 

Male: 4.5-6.7×10 6 /µL 

routine blood tests. (22) 

Female: 4.0-5.9×10 6 /µL (82) 

The occurrence of high platelets is 

divided into two medical conditions: And in Togo the Western African 

primary thrombocythemia and secondary 

Country: 

thrombocytosis. In primary 

WBC : 4.5×10 9 /L in males 

thrombocythemia, the cause of the high and 5.0×10 9 /L in females. 

platelets is not known, and it occurs as an 

Platelet: 236×10 9 /L in males 

independent condition. 

and 247×10 9 /L in females. (89) 

In secondary thrombocytosis, high 

platelets occurs as a symptom of another In Peninsula (South Africa) Black 

disease or condition, such as anemia, 

Africans aged 15-64 years (n = 819) 

infection or cancer. (22) 

aged 15-64 years, reference values 

based on the 95% reference limits 

Causes of Thrombocytopenia: 

of the haematological parameters: 

In general, a low platelet count occurs 

(Hb) in men 14.0 g/dl and women 12.4 g/dl 

because: 

World Health Organization’s Hb (< 13 g/dl 

men; < 12 g/dl women), 

• The bone marrow doesn’t make 

enough platelets. 

No significant differences were noted in 

• The bone marrow makes enough mean total and differential white blood cell 

platelets, but the body destroys them counts (WBC) between men and women. (31) 

or uses them up. 

British population: Red cell counts: 

The spleen holds on to too many 

platelets. . (7) 

Man 

5.0±0.5×10 6 /µL 

A combination of the above factors also may 

Women 

cause a low platelet count. (7) 

102 

4.3± 0.5×10 6 /µL (3) 

U S A: White blood cells count in U 

S A varies between 4000-10000 per 

micro liter (34) 


OBJECTIVES 

General objective: 

To determine the normal hematological 

parameters in the population of Khartoum 

north (K.N). 

Specific objective: 

To determine the normal count of 

RBCs, WBCs and platelets in 

Sudanese population in Khartoum 

north (K.N) . 

To to find out (detect or discover) 

causes of abnormal count. 

To make sure of known causes of 

abnormal cells, and to observe known 

and unknown relation between red 

cells, WBCs and platelet count to 

facilitate diagnosis of disease. 

To in abnormal count, I will effort to 

find information of patients to find 

out if there is any relation between 

case and (diet intake, work, habit, 

invironment, live …etc). 

To add benefits to science, that 

because red cells covering all anemia 

and more disease when link with the 

others cells (WBCs, platelets) 

To find out if there is a different in 

count with British population, Arab, 

European, Indian, African and 

Chinese or as the same. 

MATERIALS AND METHODS 

Study area: Khartoum North Area. 

Analalysis was done in central lab of 

Khartoum North Hospital. 

Sample size population: 

Total number samples were 400(200 female 

and 200 male) 

Sample population: 

-Sample which out of the normal range, was 

excluded. 

-Samples were collected from persons aged 

from (16-60) years 

Questionnaires were fulfilled. Also renal 

function test and urine general if needed; to 

exclude of any person with unfit or with 

disease. 

Healthy person’s samples were collected 

from sundaes population. 

Selection criteria: 

-Dependent on the range of standard normal 

count of RBCs, WBCs and Platelet + normal 

Hb. 

Sample technique: 

EDTA anti coagulant venous blood samples 

was collected. EDTA powerful 

103 


anticoagulant acts by its chelating effect on 

the calcium molecules in blood. (37). 

The complete blood count (CBC) was 

measured by using automated 

haematological analyzer (Sysmex kx-21) 

and thin blood film was done. Stain with 

Leishmn’s stain. 

The Sysmex kx-21 is an automatic multi 

parameter 

Blood cells counter for in vitro diagnostic 

used in clinical laboratories. 

The kx-21 performs speedly and accurate 

analysis of 18 parameters in 

Pre diluted mode: this mode is used in 

analyzing a minute amount of child, s blood, 

for instance, collected from the ear lobe or 

finger tip. In this mode, blood sample 

diluted into 1:26 before analysis is used. The 

sample aspiration procedure is the same as 

in the whole blood mode. (38) 

Ethical Clearance: Was obtained from 

Health Authorities in Khartoum North 

The kx-21 process approximately 60 

samples an hour. 

RESULTS 

The study shows Normal results of mean ± standard deviation as follows: 

TWBCs 

(5.3 ± 1.1) ×10³/µL in females 

TWBCs 

(5.1 ± 1.1) ×10³/µL in males 

RBCs 

(4.6 ± 0.4) × 10 6 /µL in females 

(4.6 ± 0.4) million/ μL in females 

RBCs 

(5.1 ± 0.5) ×10 6 /µL in males 

(5.1 ± 0.5) million/ μL in males 

Platelet 

(277.8±72.4) ×10³/µL in females 

104 


Platelet 

(246.8±67.8) ×10³/µL in males 

DISCUSSION 

The normal total WBCs count in male (5.1 ± 

1.1) ×10³/µL (4.0 – 6.2) ×10³/µL is slightly 

lower than female (5.3 ± 1.1) ×10³/µL (4.2- 

6.4) × 10 3 /µL. The normal RBCs Count in 

female (4.6 ± 0.4) million/ μL (4.2 – 5.0) 

million/ μL is lower than male (5.1 ± 0.5) 

×10 6 /µL (4.6 – 5.6) million/ μL. The 

platelet count in males (246.8±67.8) 

×10³/µL (179.0-324.6( ×10³/µL is lower 

than female(277.8±72.4) ×10³/µL (205.4- 

350.2)X10³ /µL . we observes that Platelet 

count high in female than male , that is 

conformed to the National Centre for 

Biotechnology Information, U.S. National 

Library of Medicine (The platelet count of 

healthy males was compared to that of 

healthy females. A higher platelet count in 

women was confirmed ( 

(41) that reverse to 

RBCs Count which it higher in males than 

females. 

Normal RBCs Count in male of 

Sudanese population (5.1 ± 0.5) ×10 6 /µL 

male of British population (5.0±0.5)×10 6 / (3) 

but less than American population in the 

upper limit Normal Values: males: 4.5 to 6.0 

million/cu mm blood ,females: 4.0 to 5.5 

million/cu mm blood (35) , and slightly less 

than germane population Women 4.2-5.4 

million/mm 3 Mean 4.7-6.1 million /mm 3(28) 

. German population and American 

population are the similar to each other in 

red count for both sexes. Normal RBCs 

Count in female of Sudanese population is 

slightly higher than female of British 

population Women (4.3± 0.5×10/µL) (3) and 

higher than female of Chinese population 

(3.68 – 5.13) x 10 (12) /L. (32) . Emirate people 

105 

have high upper limit (Male: 4.5-6.7×10 6 /µL 

Female: 4.0-5.9×10 6 /µL) (82) 

The normal T WBCs count of 

Sudanese population is similar to Black 

population of the Witwatersrand (South 

Africa): being 5.60 +/- 1.51 X 10 (9) /l. (31) 

but less than British population: 

7.0±3.0±×10 3 /µL (3) . WBCs count in U S A 

varies between 4000-10000 per micro liter 

(34) , but in1985 Jul varies between 4500- 

11,000/mm 3 (36) , similar to British population 

and slightly less than Chinese population 

was (3.97 – 9.15) x 10 (9) /L in males and 

(3.69 – 9.16) x 10 (9) /L in females (32) . I 

noticed in previous studies in Britain (that a 

different ethnic living in the same 

community in Britain Total and differential 

white cell counts were studied in 399 

women living in the same community in 

Britain but drawn from four different ethnic 

groups. The groups were white (northern 

European), Indian, black (African and West 

Indian), and Oriental. The total white cell 

count and absolute neutrophil count were 

significantly lower in the black group than 

in each of the other groups. The differences 

between white cell counts of Indians and 

Orientals and those of whites are minor and 

for practical purposes they can be assessed 

in relation to reference range derived for 

white s) (33) . This research confirms that the 

genes are related to variation of white count 

cells 

Also in discussion of research 

Published in the Genetics 2011, that recently 

the African null allele of rs2814778 at the 

Duffy Antigen Receptor for Chemokines 


locus on chromosome 1 was found to be 

associated with lower total leukocyte and 

neutrophil counts in African Americans 

Benign neutropenia is defined as an 

absolute neutrophil count (ANC) of less than 

1.5×10 9 cells/L on repeated occasions. It 

occurs in up to 40% of individuals of 

African descent and is present in 5% of adult 

African Americans compared to

CONCLUSION 

The Normal Reference Value of Blood Cell 

Count, Red, white and Platelet in the adult 

healthy population Of Khartoum North 

Area: 

Total normal WBC count in females: 

(4.2-6.4)×10³/µL 

(5.3 ± 1.1) ×10³/µL. 

Total normal WBC count in males: 

(4.0-6.2)×10³/µL. 

(5.1 ± 1.1) ×10³/µL 

RBCs count in females : 

(4.8-5.0) ×10 6 / μL (4.8-5.0 million/ μL) 

(4.6 ± 0.4) ×10 6 / µL. 

RBCs count in males : ( 4.6-5.6) ×10 6 / 

μL(4.6-5.6) million 

Platelet count in female: (205.4-350.2) 

×10³/µL. 

(277.8±72.4) ×10³/µL. 

Platelet count in male: 

(179.0-324.6)10³/µL. 

(246.8±67.8) ×10³/µL 

RECOMMENDATION 

‣ -I recommend to do good studies of 

count cells from healthy population, 

don’t from community because some 

of community population has 

disease. 

‣ I do my research from adult healthy 

population hence I suggest others my 

fellows to do studies from children. 

‣ Also I recommend to do others 

studies from different states and 

different climes or environmental. 

REFERENCES 

1/Hoffbrand A.V, pett.J.E, MOSS.P.A.H 

Essential haematology fourth edition 2001 

Reprinted with corrections 2002, 2003, 

2004. Hong Kong printed and bound in Italy 

2/Janet.S.R, Kathleeen.J.W.W. 

Ross and Willson, Anatomy and 

Physiology, Fifth edition 1981. 

ELBS edition reprinted 1982 

107 

William clowes (Beccles) limited, Beccles 

and London. 

3/Lewis.S. M,Barbara J.B, 

Dacie and Lewis practical haematology 

Ninth edition 2001 

reprinted 2001 . London 

4/Internet: Dr.Rufus Medical Website 

5 /Internet Medical Technologist 


6/ Hughes N.C.-Jones. Lecture notes on 

haematyology 

Medical school, London .third edition 

1979 

7 / National Heart, Lung and Blood 

Institute: Sickle Cell Anemia 

Mayo Clinic: Sickle Cell Anemia 

National Heart, Lung and Blood 

Institute: Thalassemias 

Mayo Clinic: Thalassemia 

National Heart, Lung and Blood 

Institute: Pernicious Anemia 

http://www.nhibi.nih.gov/health/dd/ 

8/www123esaaF.com/QEA/Anemia.html 

9/www.medic8.com/blood-disorders/irondeficiency-anaemia.htm 

- 

10/ Firkin. وF Chesterman .C, Penington. 

D, Rush.P 

de Grouchy’s .clinical haematology in 

medical practice. 

Fifth Edition 

11/ www Buzzle.com/articles/high white 

blood cell count. 

Jupiterimages/Comstock/Getty Images 

Mayo Clinic - Low White Blood Cell 

Count: Causes 

National Institutes of Health - WBC 

Count 

University of Pennsylvania - Low White 

Blood Cell Count 

12/By Amber J. Tresca, About.com Guide 

Updated November 03, 2011 

About.com Health’s Disease and Condition 

content is reviewed by the Medical Review 

Board 

13/Amber J. Tresca, About.com Guide, 

2011, Health’s Disease and Condition 

content, reviewed by the Medical Review 

Board 

14/ By Mayo Clinic staff 

www.mayoclinic.com/.../high-white...cellcount 

15/ Jupiterimages/Comstock/Getty Images 

16/ www.bettermedicine.com/article/highplatelets 

- www.bettermedicine.com result 

17/HealthBoards.com, 

www.healthboards.com/boards/showthread 

18/ Stewart. F.S .BIGGEOR, S. Hand Book 

of Bacteriology for students and 

practitioners of medicine .seventh edition 

London 1959. 

19/ Hoffbrad A.V., Lewis. S.M. 

postgraduate haematology, second Edition. 

Repeated 1983 

20/ Mayo Clinic, 

www.mayoclinic.com/high-white.cell-count, 

www.mayoclinic.com/health/thrombocytope 

nia/DS00691/DSECTION=causes 

21/ Haematology. House officer series 

medial east edition, Forth edition 1997. 

108 


22/ www.bettermedicine.com/article/highplatelets 

- www.bettermedicine.com result 

23/http://www.ask.com/questionsabout/Foods-Increase-My-Platele, 

http://answers.ask.com/Health/Diseases/wha 

t_foods_incr... 

24/http://www.ehow.com/how_6929638_inc 

rease-plateletseat...http://www.ask.com/questionsabout/Foods-Increase-My-Platelet 

25/http:// 

www.ehow.com/how_5690700_increaseplatelet-leve... 

26/http://answers.ask.com/Health/Diseases/h 

ow_to_increase... 

27/ http:// 

www.ehow.com/how_5127818_increaseplatelet-low- 

platelets 

28 

/http://www.hindawi.com/isrn/hematology/2 

011/736062/ 

www.ncbi.nlm.nih.gov › ... › BMC Blood 

Disord v.11; 2011 

29/http://www.hindawi.com/isrn/hematolog 

y/2011/736062/ 

30/ S Afr Med J. 1987 Jul 18; 72(2):135-6 

S Afr Med J. 1987 Jul 18; 72(2):135-6 

31/Badenhorst CJ, Fourie J, Steyn K, Jooste 

PL, Lombard CJ, Bourne L, ,East Afr Med 

J. 1995 Jan; 72(1):19-24. 

32/ Cong YL, Jin DM, Wang HL, Okada T, 

Peng ZH., .; Coordination Group for 

Reference Range of Venous Blood 

Examination in Chinese Adults, Zhonghua 

Yi Xue Za Zhi. 2003 Jul 25;83(14):1201-5 

109 

33/ Bain B, Seed M, Godsland I, J Clin 

Pathol. 1984 Feb; 37(2):188-93 

34/ national center for biotechnology 

information U.S National library of 

medicine8600 Rckville pick bethesade 

MD20894 U S A 

35/National Centre for Biotechnology 

Information, U.S. National Library of 

Medicine 

www.nurseslearning.com/Rockville Pike, 

Bethesda MD, 20894 USA 

36/ National Center for Biotechnology 

Information, U.S. National Library of 

Medicine 8600 

Rockville Pike, Bethesda MD, 20894 USA 

37/. Dacie.J. V & Lewis, S.M .Practical 

Haematology, Eight editions repeated 

38/ Sysmex Corporation’s KOBE, JABAN, 

Sysmex operations manual, Automated 

hematology analyzer Kx-21 Code NO 461- 

2261-printed in Japan September 1998. 

39/Mary. c.haven, GregoryA .M.S., Tetrault, 

Jerald R.S, Laboratory instrumentation. 

Fourth Edition, 1995, 

http://www.medialabinc.net/normalperipheral-blood-cells.aspx 

41/ Scand J Haematol. National Center for 

Biotechnology Information, U.S. National 

Library of Medicine, Rockville Pike, 

Bethesda MD, 20894 USA, 1985 

Jul;35(1):77-9. 

42/ htt://www0plosgentics.org / 2011, 

PLoS Genetics.

Normal Reference Value of Blood Cell Count, Red, white and ...

Create successful ePaper yourself

Delete template?

Save as template?