Manual of basic techniques for a health laboratory - libdoc.who.int

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320 Manual of basic techniques for a health laboratoryThere are two main patterns of distribution of different types ofleukocyte:● One pattern shows a majority of lymphocytes (this type is seen in infantsand children under 10 years).● The other pattern shows a majority of neutrophils (seen in newborninfants, children over 10 years and adults).Each type of leukocyte may be reported in terms of its numberconcentration (i.e. number of cells per litre) instead of as a number fraction.The number concentration is calculated by multiplying the numberfraction of a particular type of leukocyte by the total leukocyte numberconcentration.Example:leukocyte number concentration = 5 ¥ 10 9 /lneutrophil number fraction = 0.42neutrophil number concentration = 0.42 ¥ 5 ¥ 10 9 = 2.1 ¥ 10 8 /l.Fig. 9.111 Table for recording thedifferent types ofleukocytesN: neutrophils; E: eosinophils;B: basophils; L: lymphocytes;M: monocytes.Abnormal findings● Neutrophilia is an increased proportion of neutrophils (above 0.65). Itis particularly common in infections.● Eosinophilia is an increased proportion of eosinophils (above 0.05).It almost always suggests a parasitic infection localized in the tissues(e.g. schistosomiasis, filariasis, hookworm, ascariasis). It can also becaused by allergies.Table 9.12 Normal leukocyte type number fractions, by age groupAge groupCell type aNeutrophils Eosinophils Basophils Lymphocytes MonocytesNewborn infants 0.55–0.65 0.02–0.04 0.00–0.01 0.30–0.35 0.03–0.06Infants (up to 0.40–0.48 0.02–0.05 0.00–0.01 0.40–0.48 0.05–0.101 year, excludingnewborns)Infants (1–4 years) 0.36–0.48 0.02–0.05 0.00–0.01 0.44–0.54 0.03–0.06Children (10 years) 0.45–0.55 0.02–0.05 0.00–0.01 0.38–0.45 0.03–0.06Adults 0.55–0.65 0.02–0.04 0.00–0.01 0.25–0.35 0.03–0.06aTo obtain values in traditional units (i.e. as percentages), multiply each value by 100. The differentialleukocyte count is calculated by multiplying the percentage of a particular type of leukocyte (e.g.neutrophils) by the total leukocyte count and dividing by 100.Example:total leukocyte count = 5000/mm 3percentage of neutrophils = 42%“absolute” neutrophil count = (42 ¥ 5000)/100 = 2100/mm 3 .●●●●Lymphocytosis is an increased proportion of lymphocytes (above 0.35 in adultsand above 0.45 in children). It is found in certain virus infections (e.g. measles),certain chronic infections (e.g. malaria, tuberculosis) and some toxic conditions.Monocytosis is an increased proportion of monocytes (above 0.06). It occurs incertain bacterial infections (e.g. typhoid fever, infectious mononucleosis) andcertain parasitic infections (e.g. malaria, kala-azar (visceral leishmaniasis)).Neutropenia is a decreased number of neutrophils. It may occur in certain infections(e.g. sepsis) and some other diseases.Lymphopenia is a decreased number of lymphocytes and may occur in AIDS.
9. Haematology 3219.14 Determination of the thrombocyte numberconcentration9.14.1 Materials●●MicroscopeImmersion oil● Well-spread blood film stained with a Romanowsky stain (see section 9.10.3).9.14.2 Microscopic examinationUsing the ¥ 100 oil-immersion objective, count the number of thrombocytes in 20fields and make a rough estimate of the number of erythrocytes per field.Calculate the ratio of thrombocytes to erythrocytes. If the erythrocyte number concentration(see section 9.5) is known, the thrombocyte count can be estimated. Ifnot, a rough estimate of the thrombocyte count, either “normal”, “high” or “low”,can be based on a ratio of approximately one thrombocyte per 500–1000 erythrocytesbeing normal.Reference rangeTable 9.13 shows the reference ranges for different age groups.Table 9.13 Normal thrombocyte counts, byage groupAge group Thrombocyte count (per mm 3 )Infants (< 1 year) 3.5–6.6 ¥ 10 5Children (1–15 years) 2.5–5.1 ¥ 10 5Adults 1.7–4.0 ¥ 10 5
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M A N U A LO F B A S I CTECHNIQUESF
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ContentsiManualofbasic techniques f
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ContentsiiiContentsPrefacex1. Intro
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viManual of basic techniques for a
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viiiManual of basic techniques for
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xManual of basic techniques for a h
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Table 3.2 Dispatch of specimens 92
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7. Examination of urine 231Part III
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7. Examination of urine 2337. Exami
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7. Examination of urine 2357.2.3 Me
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7. Examination of urine 237Table 7.
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7. Examination of urine 239The anal
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7. Examination of urine 241MethodCo
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7. Examination of urine 243Table 7.
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7. Examination of urine 245Fig. 7.2
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7. Examination of urine 2497.2.8 De
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7. Examination of urine 251Reuse of
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8. Examination of cerebrospinal flu
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9. Haematology 2659. HaematologyHae
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9. Haematology 2679.2 Collection of
Page 281 and 282: 9. Haematology 269Fig. 9.13 Feeling
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Page 285 and 286: 9. Haematology 273Table 9.2 Sample
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Page 289 and 290: 9. Haematology 277Calibration of th
Page 291 and 292: 9. Haematology 279Errors in haemogl
Page 293 and 294: 9. Haematology 281Fig. 9.28 Micro s
Page 295 and 296: 9. Haematology 283Fig. 9.34 Centrif
Page 297 and 298: 9. Haematology 285concentration is
Page 299 and 300: 9. Haematology 287Measurement techn
Page 301 and 302: 9. Haematology 289●●●Graduate
Page 303 and 304: 9. Haematology 2911 litre, so multi
Page 305 and 306: 9. Haematology 293Fig. 9.45 Materia
Page 307 and 308: 9. Haematology 295Very high ESR val
Page 309 and 310: 9. Haematology 2979.9 Observation o
Page 311 and 312: 9. Haematology 2999.10 Preparation
Page 313 and 314: 9. Haematology 301Fig. 9.64 Making
Page 315 and 316: 9. Haematology 303Drying the filmAd
Page 317 and 318: 9. Haematology 3054. Examine the co
Page 319 and 320: 9. Haematology 307Fig. 9.77 Normal
Page 321 and 322: 9. Haematology 309Fig. 9.85 Anisocy
Page 323 and 324: 9. Haematology 311Fig. 9.92 Polymor
Page 325 and 326: 9. Haematology 313Immature granuloc
Page 327 and 328: 9. Haematology 315Fig. 9.104 Mixing
Page 329 and 330: 9. Haematology 317Fig. 9.108 Prepar
Page 331: 9. Haematology 319Heinz bodiesHeinz
Page 335 and 336: 10. Blood chemistry 323Fig. 10.1 De
Page 337 and 338: 10. Blood chemistry 325Table 10.1 B
Page 339 and 340: 10. Blood chemistry 32710.2.4 Resul
Page 341 and 342: 11. Immunological and serological t
Page 363 and 364: Annex. Reagents and their preparati
Page 381 and 382: IndexNote: Page numbers in bold ref
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Index 371Centrifuges 32, 69-72, 69-
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Index 373Endolimax nanus 114, 114,
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Index 375Hyaline casts, urine 243,
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Index 377Microhaematocrit equipment
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Index 379Protozoablood 173-194, 178
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Index 381Smears (continued)preparat
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Index 383Thiomersal-iodine-formalde
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