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Un professionnel peut aussi interpr\u00e9ter vos r\u00e9sultats avec vous.<\/p><div class=\"oc-fiche-cta-b\"><a class=\"oc-p\" href=\"https:\/\/cliniqueomicron.ca\/prelevements-medicaux\/\">Blood sampling<\/a><a class=\"oc-s\" href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\">Make an appointment<\/a><a class=\"oc-s\" href=\"tel:+15146063350\">514 606-3350<\/a><\/div><\/div>\n\n\n <div class=\"co-intro\">\n The complete blood count (CBC) - also known as the complete blood count (CBC) or hemogram - is the most widely prescribed blood test in clinical medicine. It provides automated quantification of the three cell lineages of peripheral blood (red blood cells or erythrocytes, white blood cells or leukocytes, and platelets or thrombocytes) and their derived parameters, and is the essential baseline assessment for the vast majority of clinical situations: annual health check-up, investigation of fatigue or weight loss, preoperative assessment, chemotherapy monitoring, investigation of infection or inflammation, screening for hemopathy. In Quebec, FSC is performed on a venous blood sample taken in an EDTA tube (purple or lavender cap) and analyzed by a hematology analyzer such as Sysmex, Beckman Coulter DxH or Abbott CELL-DYN, which simultaneously measures all parameters by electrical impedance (Coulter method) and laser diffraction. When the automated system detects morphological anomalies or critical values (alarms), a peripheral blood smear is taken manually by a technician or hematologist to confirm and clarify the anomalies. The standard FSC includes erythrocyte parameters (hemoglobin, hematocrit, erythrocyte count, VGM, TGMH, CGMH, IDR), leukocyte parameters (total leukocyte count and differential formula: neutrophils, lymphocytes, monocytes, eosinophils, basophils) and platelet parameters (platelet count, mean platelet volume - MPV). Clinical interpretation of FSC must always be integrated into the clinical context, and can never replace clinical examination - a value slightly outside the reference range may be normal for a given individual, and a value within the limits may mask significant pathology.\n <\/div>\n\n <h2>Reference Values and Erythrocyte Parameters<\/h2>\n <ul class=\"co-list\">\n <li><strong>Erythrocyte parameters - normal adult values:<\/strong> hemoglobin (Hb): female 120-160 g\/L + male 130-175 g\/L - the parameter most commonly used clinically to define anemia (WHO: Hb <120 g\/L female + <130 g\/L adult male); hematocrit (Ht): female 0.36-0.46 + male 0.40-0.52 - volume proportion of erythrocytes in whole blood; erythrocyte count (RBC): female 3.8-5.2 \u00d7 10\u00b9\u00b2\/L + male 4.5-5.9 \u00d7 10\u00b9\u00b2\/L; mean corpuscular volume (MGV): 80-100 fL - key parameter for classification of anemias (microcytic 100 fL); mean globular hemoglobin content (TGMH): 27-33 pg - amount of Hb per erythrocyte - low in martial deficiency + thalassemia (hypochromia); mean globular hemoglobin concentration (CGMH): 320-360 g\/L - degree of erythrocyte hemoglobin saturation - low in martial deficiency (hypochromia) + very high in hereditary spherocytosis (>360 g\/L); erythrocyte distribution index (RDI or RDW): 11.5-14.5 % - measure of erythrocyte size heterogeneity (anisocytosis) - high in martial deficiency + myelodysplastic syndromes + hemolytic anemia - normal in thalassemia minor (homogeneous microcytosis) - very useful to distinguish martial deficiency (high RDW) vs. thalassemia minor (normal RDW) in microcytosis ; reticulocytes (often requested separately but are part of the extended FSC): normal value 20-100 \u00d7 10\u2079\/L (or 0.5-2.5 %) - high reticulocytes = regenerative anemia (hemolysis + acute hemorrhage + regeneration after treated deficiency) - low or normal reticulocytes in anemia = aregenerative anemia (central = aplasia + bone marrow invasion + deficiency)<\/li>\n <li><strong>Leukocyte parameters \u2014 normal adult values:<\/strong> total leukocytes: 4.0-10.0 \u00d7 10\u2079\/L - leukopenia 10.0 G\/L; leukocyte differential formula - normal values (adult): neutrophils (PNN): 1.8-7.5 \u00d7 10\u2079\/L (50-70 % of leukocytes) - severe neutropenia <0.5 G\/L = major infectious risk + moderate neutropenia 0.5-1.0 G\/L + mild 1.0-1.8 G\/L; lymphocytes: 1.0-4.8 \u00d7 10\u2079\/L (20-40 %) - lymphopenia 4.8 G\/L (viral infections + CLL + lymphoma); monocytes: 0.2-1.0 \u00d7 10\u2079\/L (2-8 %) - monocytosis in chronic infections + CMML (chronic myelomonocytic leukemia); eosinophils: 0.05-0.5 \u00d7 10\u2079\/L (1-5 %) - hypereosinophilia >0.5 G\/L: parasitoses + allergies + drugs + clonal hypereosinophilia (FIP1L1-PDGFRA); basophils: 0.01-0.10 \u00d7 10\u2079\/L (<1 %) - basophilia in CML + polycythemia vera + mastocytosis; physiological and ethnic variants of leukocyte count: benign ethnic neutropenia (formerly benign neutropenia of Afro-descendants): neutrophils 1.0-1.8 G\/L in individuals of African or Yemeni descent without pathology - linked to a polymorphism of the DARC gene (Duffy antigen) - no increase in infectious risk - important to know to avoid unnecessary investigations<\/li>\n <li><strong>Platelet parameters - adult normal values:<\/strong> platelet count: 150-400 \u00d7 10\u2079\/L - thrombocytopenia <150 G\/L (mild 100-150 + moderate 50-100 + severe 450 G\/L (reactive vs. clonal); mean platelet volume (MPV or MPV): 7-12 fL - high MPV = young, large platelets (peripheral destruction - ITP + TTP) + low MPV = reduced production (aplasia + chemotherapy); EDTA platelet aggregates: EDTA-dependent false thrombocytopenia (anti-platelet antibodies agglutinate in presence of EDTA) \u2192 confirm on citrate tube \u2192 normal result on citrate confirms pseudo-thrombocytopenia - to be systematically evoked in the presence of any isolated asymptomatic thrombocytopenia without suggestive clinical context; pre-analytical - conditions sampling on FSC quality: difficult sampling with hemolysis (falsely low Hb + falsely high CGMH) + coagulated sampling (unusable results) + delay between sampling and analysis >4h at room temperature (morphological changes in leukocytes + platelet degranulation) + storage at 100 G\/L (interference on Hb measurement by turbidity)<\/li>\n <\/ul>\n\n <h2>Interpretation of CBC anomalies<\/h2>\n <table class=\"co-table\">\n <colgroup><col style=\"width:200px;\"><col style=\"width:42%;\"><col><\/colgroup>\n <thead>\n <tr><th>FSC anomaly<\/th><th>Main causes and diagnostic orientation<\/th><th>Follow-up assessment and management<\/th><\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Hypochromic microcytic anemia<br><small style=\"font-weight:400;color:#7a8fa0;\">VGM <80 fL + low TGMH<\/small><\/td>\n <td>Hypochromic microcytic anemia is the most common form of anemia in general practice - its two main causes are martial deficiency and thalassemia minor, which require precise clinical and biological distinction as their treatments are radically different; martial deficiency (iron deficiency): most frequent cause of anemia worldwide - microcytosis + hypochromia + high IDR (>14.5 %) + marked anisocytosis on smear - causes: chronic blood loss (menorrhagia + digestive occult rectorrhagia + intravascular haemolysis) + inadequate intakes (strict veganism + malnutrition) + malabsorption (celiac disease + gastrectomy + prolonged PPIs - PPIs reduce the gastric acidity required to reduce ferric iron to ferrous) - martial status : ferritin (reflection of iron stores - low <15 \u00b5g\/L in true deficiency - falsely normal or high in inflammatory states) + serum iron (low) + transferrin (high) + transferrin saturation coefficient - TSC (low <15 %) + saturation coefficient = serum iron \/ total binding capacity \u00d7 100; thalassemia minor (thalassemic trait): marked microcytosis + NORMAL IDR (homogeneous RBC population) + Mentzer ratio = GMV \/ number of RBCs: 13 = probable martial deficiency - normal or elevated ferritin - Hb electrophoresis: Hb A2 >3.5 % = \u03b2-thalassemia minor (Hb A2 normal in \u03b1-thalassemia - diagnosis by PCR in genetics) - no indication for iron supplementation; anemia of chronic\/inflammatory diseases: normocytic or slightly microcytic + elevated or normal ferritin + low iron + low transferrin (in contrast to martial deficiency) + elevated hepcidinemia - context: chronic inflammation + neoplasia + renal failure + autoimmune disease; lead intoxication: microcytosis + basophilic punctations on smear + elevated blood lead + occupational or environmental context<\/td>\n <td>1st-line workup for microcytic anemia: ferritin (most reliable parameter of iron stores) + serum iron + transferrin + CST + reticulocytes + peripheral blood smear; if ferritin is low (confirmed martial deficiency): search for cause: in women of childbearing age \u2192 menorrhagia (most frequent cause) \u2192 gynaecological work-up; in any adult without obvious cause \u2192 occulted rectal bleeding \u2192 digestive work-up (FIT - faecal immunological test + colonoscopy if FIT positive or digestive symptoms) \u2192 search for celiac disease (anti-transglutaminase IgA + total IgA antibodies) ; if normal or elevated ferritin + microcytosis + normal IDR \u2192 Hb electrophoresis \u2192 thalassemia; treatment of martial deficiency: ferrous iron PO (ferrous fumarate + ferrous gluconate + ferrous sulfate 150-200 mg elemental iron\/d fasting or 1h before meal) - increase in reticulocytosis in 7-10d (response criterion) + Hb normalization in 4-8 weeks + treatment for 3-6 months after Hb normalization to replenish reserves (ferritin >50 \u00b5g\/L); IV iron (ferric carboxymaltose - Ferinject + iron sucrose - Venofer): indicated if digestive intolerance to oral iron + malabsorption + severe symptomatic deficiency (Hb <90 g\/L) + chronic renal failure on EPO + 2nd-3rd trimester pregnancy + refusal of oral iron - superior efficacy to oral iron in terms of rapid correction of ferritin; monitoring under treatment: CBC + ferritin at 4-6 weeks (expected response) + at 3 months (Hb normalization)<\/td>\n <\/tr>\n <tr>\n <td>Macrocytic anemia<br><small style=\"font-weight:400;color:#7a8fa0;\">VGM >100 fL<\/small><\/td>\n <td>Macrocytic anemia groups together two mechanistically distinct major categories: megaloblastic macrocytosis (DNA synthesis abnormality due to vitamin B12 or folate deficiency) and non-megaloblastic macrocytosis (various causes without DNA synthesis abnormality); megaloblastic macrocytosis - vitamin B12 (cobalamin) deficiency: VGM often >110-120 fL + macro-ovalocytes + hypersegmentation of neutrophils (\u22655 lobes in >5 % of PNN = highly specific criterion) + anemia + pancytopenia possible in severe forms - specific neurological manifestations absent in folate deficiency: peripheral neuropathy (lower limb paresthesias + ataxia) + subacute combined degeneration of the spinal cord (posterior cord + spinocerebellar involvement) - causes: malabsorption (autoimmune atrophic gastritis = Biermer's anemia - antiintrinsic factor + anti-parietal cell antibodies - the most frequent cause of symptomatic low B12) + gastrectomy + ileal Crohn's disease + ileal resection + strict veganism (absence of animal products) + Metformin (reduces ileal B12 absorption) + long-term PPIs; folate deficiency (folic acid = vitamin B9): morphology identical to B12 deficiency - absence of neurological impairment - causes : inadequate intake (alcoholism + anorexia + diet low in green vegetables) + malabsorption (celiac disease) + antifolate drugs (methotrexate + trimethoprim + phenytoin + sulfasalazine) + increased needs (pregnancy - folates are essential for neural tube closure - periconceptional supplementation 0.4-5 mg\/d depending on risk factors) + chronic hemolysis; non-megaloblastic macrocytosis - frequent causes: alcoholism (macrocytosis without anemia or morphological abnormality of the smear - direct mechanism on the erythrocyte membrane) + hypothyroidism + chronic liver disease + drugs (hydroxyurea + zidovudine + azathioprine + leflunomide) + myelodysplastic syndromes (MDS - macrocytosis + cytopenia + dysplasia on smear - myelogram mandatory) + bone marrow regeneration (reticulocytosis - reticulocytes larger than mature RBCs)<\/td>\n <td>1st-line workup for macrocytosis: VGM + blood smear (macro-ovalocytes + PNN hypersegmentation = megaloblastic) + serum B12 assay + erythrocyte folates (erythrocyte folates better reflect folic status than serum folates, which vary with recent intake) + TSH + GGT + liver workup + complete blood count (pancytopenia?) + reticulocytes; if low B12 : search for cause \u2192 antiintrinsic factor antibodies (specificity 95 % for Biermer if positive) + anti-parietal cell antibodies (sensitivity 80 % but less specific) + gastroscopy if Biermer suspicion (fundic biopsies - atrophic gastritis + metaplasia) + colonoscopy if digestive symptoms + urinary MMA assay + homocysteinemia (elevated in both B12 and folate deficiencies) - useful in case of borderline B12 values; treatment of B12 deficiency : oral B12 (cyanocobalamin 1,000 \u00b5g\/d PO - as effective as IM in most cases if no total malabsorption because a fraction of B12 is absorbed by passive diffusion independently of the intrinsic factor) + IM B12 (cyanocobalamin 1,000 \u00b5g IM\/d \u00d7 7d \u2192 weekly \u00d7 4 \u2192 monthly for life) - if Biermer or total malabsorption \u2192 IM or nasal for life; folate deficiency treatment: folic acid 1-5 mg\/d PO \u00d7 3-4 months + correction of cause - NEVER supplement with folates alone without excluding B12 deficiency (risk of masking the hematological manifestations of B12 deficiency while allowing irreversible neurological damage to progress); MDS: bone marrow work-up (myelogram + bone marrow biopsy + cytogenetics + NGS) + hematology referral.<\/td>\n <\/tr>\n <tr>\n <td>White blood cell abnormalities<br><small style=\"font-weight:400;color:#7a8fa0;\">Leukocytosis + leukopenia + differential count<\/small><\/td>\n <td>Leukocyte count abnormalities are frequent and their interpretation requires analysis of the complete differential formula and clinical context; neutrophilia (PNN >7.5 \u00d7 10\u2079\/L) : acute bacterial infection (most frequent - increased PNN + toxic granulations + D\u00f6hle bodies on smear in severe infections) + leukemoid reaction (PNN >30 G\/L with myelemia - severe infections + G- drugs.CSF + neoplastic soliditis) + corticosteroids (PNN demargination - rapid increase in PNN without infection) + smoking (moderate chronic neutrophilia) + physical stress (surgery + infarction) + pregnancy + polycythemia vera + chronic myeloid leukemia (CML - PNN >30 G\/L + myelemia + basophilia + spleno - BCR-ABL +) ; neutropenia (PNN 4.8 \u00d7 10\u2079\/L): acute viral infections (EBV + CMV + adenovirus - atypical lymphocytosis with large activated lymphocytes on smear) + pertussis (marked lymphocytosis in catarrhal phase - small mature lymphocytes) + CLL (persistent lymphocytosis + monoclonal + Gumprecht shadows on smear + CD19+CD5+ immunophenotyping mandatory) + leukemic non-Hodgkin's lymphoma; eosinophilia (>0.5 \u00d7 10\u2079\/L) : invasive tissue parasitoses (toxocariasis + filariasis + echinococcosis + hookworm - intraluminal parasites such as pinworms do not give hypereosinophilia) + allergies + asthma + drugs (DRESS) + Churg-Strauss disease (EGPA) + hypereosinophilic syndrome (FIP1L1-PDGFRA if >1.5 G\/L persistent \u2192 imatinib) + T lymphoma; monocytosis (>1.0 \u00d7 10\u2079\/L) : chronic infections (tuberculosis + brucellosis + endocarditis + leishmaniasis) + CMML (chronic myelomonocytic leukemia - persistent monocytes >1 G\/L + dysplasia + myelogram).<\/td>\n <td>Diagnostic approach to leukocyte abnormalities: moderate leukocytosis (10-30 G\/L) in obvious infectious or inflammatory context \u2192 no immediate further investigation + treatment of cause + FSC check at 4-6 weeks after resolution of context; persistent unexplained leukocytosis >12-15 G\/L or >30 G\/L \u2192 blood smear mandatory \u2192 if myelemia (promyelocytes + myelocytes + metamyelocytes) + basophilia \u2192 CML \u2192 BCR-ABL by PCR or FISH \u2192 urgent hematology; persistent lymphocytosis >5 G\/L in adults >45 years \u2192 lymphocyte immunophenotyping (flow cytometry) \u2192 LLC exclusion \u2192 if LLC confirmed (CD19+CD5+CD23+ + kappa or lambda restriction) \u2192 Binet classification \u2192 hematology reference ; isolated neutropenia \u2192 complete drug review \u2192 follow-up CBC at 3-4 weeks after discontinuation of suspect drug \u2192 if persistent \u2192 ANA + B12 + folates + HIV serology + ANCA \u2192 if unexplained \u2192 myelogram + hematology consultation; fever + neutropenia (1.5 G\/L \u2192 parasite workup (serologies + coproparasitology \u00d7 3) + ANA + ANCA + mast cell tryptase + BCR-ABL + FIP1L1-PDGFRA + myelogram \u2192 referral to internal medicine or hematology<\/td>\n <\/tr>\n <tr>\n <td>Platelet abnormalities<br><small style=\"font-weight:400;color:#7a8fa0;\">Thrombocytopenia + thrombocytosis<\/small><\/td>\n <td>Platelet abnormalities are frequent at FSC and require a rigorous diagnostic approach taking into account the level of thrombocytopenia and the clinical context; thrombocytopenia <150 G\/L - approach by mechanism: false EDTA-dependent thrombocytopenia (pseudo-thrombocytopenia) : always exclude in 1st intention - confirm by sampling on citrate or heparin tube + call laboratory to check platelet aggregates on smear - accounts for 15-30 % of incidental thrombocytopenia discovered on routine workup; thrombocytopenia due to peripheral destruction (regenerative - high MPV - normal reticulocytes): IPT (primary immunological thrombocytopenia): isolated thrombocytopenia <100 G\/L + normal smear + exclusion of secondary causes - anti-platelet antibodies (low sensitivity + specificity - not recommended routinely) - diagnosis of exclusion - treatment if platelets 0.1 % + ADAMTS13 450 G\/L: reactive (most frequent): martial deficiency + infection + inflammation + post-splenectomy + solid cancer + corticosteroids - benign + treatment of cause; essential (clonal): essential thrombocythemia (ET): persistent thrombocytosis >450 G\/L + JAK2 V617F mutation (in 55 % of ETs) + CALR mutation (25 %) + MPL (5 %) \u2192 myelogram + molecular biology \u2192 hematology \u2192 thrombotic + hemorrhagic risk<\/td>\n <td>Clinical thresholds for thrombocytopenia and practical steps to be taken: thrombocytopenia 100-150 G\/L: generally asymptomatic - FSC check-up at 4-8 weeks + verification of pseudothrombocytopenia + drug history + HIV serology + TSH + ANA if suggestive context; thrombocytopenia 50-100 G\/L : mild to moderate bleeding risk - minor surgery possible if >80 G\/L - avoid NSAIDs + aspirin + anticoagulants - active etiological investigation mandatory - refer to haematology if cause not obvious; thrombocytopenia <50 G\/L : significant bleeding risk - contraindication to lumbar punctures + deep biopsies without prior platelet transfusion if <50 G\/L - contraindication to elective surgery if <50 G\/L - hospitalization if <20 G\/L or active bleeding; thrombocytopenia <20 G\/L without obvious cause \u2192 hospitalization + urgent investigation + hematology referral; platelet transfusion: prophylactic threshold (without bleeding): platelets <10 G\/L in the context of drug-induced aplasia + <20 G\/L if fever or invasive procedure planned + <50 G\/L before non-neurosurgical surgery + 50 % or platelets <100 G\/L \u2192 score 4Ts \u2192 discontinue heparin if HIT suspected + switch non-heparin anticoagulant<\/td>\n <\/tr>\n <tr>\n <td>Polyglobulia and polycythemia<br><small style=\"font-weight:400;color:#7a8fa0;\">High hemoglobin and hematocrit<\/small><\/td>\n <td>Elevated hemoglobin and hematocrit may reflect a true increase in erythrocyte mass (polyglobulia vera) or a decrease in plasma volume (relative polyglobulia or pseudo-polyglobulia); relative polyglobulia (pseudo-polyglobulia): Hb and Ht elevated by hemoconcentration without increase in erythrocyte mass - causes: severe dehydration + diuretics + profuse vomiting + extensive burns + Gaisbock syndrome (obese man + hypertension + smoker + stress) - treatment: correction of cause + hydration; true polyglobulia - definition: Hb >185 g\/L in men + >165 g\/L in women (WHO 2022) OR hematocrit >52 % in men + >48 % in women - classification: secondary polyglobulia (appropriate - chronic hypoxia \u2192 EPO increase \u2192 compensatory polyglobulia) : COPD + sleep apnea + altitude + smoking + cyanogenic heart disease + high-affinity hemoglobin - serum EPO dosage (high) + O\u2082 saturation (low if respiratory cause) + PSG if apneas suspected; inappropriate polyglobulia (ectopic EPO secretion): renal cell carcinoma + hemangioblastoma + hepatocarcinoma + uterine fibroids - elevated serum EPO + abdominal imaging; polycythemia vera (PV - clonal myeloproliferative disease): high Hb + Ht + leukocytosis + thrombocytosis + splenomegaly + aquagenic pruritus (pathognomonic) + low EPO + JAK2 V617F mutation (present in 95 % of PV) - major thrombotic risk (stroke + MI + portal vein thrombosis) + risk of transformation into myelofibrosis or AML - treatment: bloodletting (phlebotomy) to maintain Ht <45 % + aspirin 100 mg\/d + hydroxyurea (if high risk) + ruxolitinib (anti-JAK2 - if resistance or intolerance to hydroxyurea)<\/td>\n <td>Approach to polycythemia on FSC: step 1: check preanalytical conditions (prolonged tourniquet \u2192 pseudo-increased Ht) + exclude dehydration + repeat FSC on fresh sample if in doubt; step 2: if Hb >165 g\/L woman or >185 g\/L man persists \u2192 serum EPO assay + O\u2082 saturation (SpO\u2082 rest + effort) + search for JAK2 V617F mutation by PCR; interpretation: JAK2 V617F positive \u2192 polycythemia vera \u2192 myelogram + osteo-medullary biopsy + thrombotic workup \u2192 emergency hematology; JAK2 negative + EPO low \u2192 other myeloproliferative mutation (exon 12 JAK2 + CALR + MPL) \u2192 myelogram; high EPO + low SpO\u2082 \u2192 secondary respiratory polyglobulia \u2192 spirometry + PSG + chest CT + ECG; high EPO + normal SpO\u2082 \u2192 ectopic polyglobulia \u2192 abdomino-pelvic CT (renal carcinoma ++) + abdominal ultrasound; emergency treatment if severe symptomatic polyglobulia (Ht >55 % + signs of hyperviscosity: headache + flush + dizziness + tinnitus + erythromelalgia): phlebotomy (150-450 mL) + hydration \u2192 hematology<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2139\ufe0f<\/span>\n <span><strong>FSC Critical Values \u2014 Laboratory Alert Thresholds:<\/strong> Quebec laboratories (according to Accreditation Canada + LSPQ standards) automatically transmit the following critical values to the prescribing physician without delay: hemoglobin 200 g\/L \u2014 leukocytes 30 G\/L \u2014 platelets 1,000 G\/L \u2014 presence of circulating blasts. These values require immediate clinical re-evaluation and medical action within a defined timeframe (critical values protocol). A critical result received by the laboratory must be communicated to the physician or responsible nurse within a maximum of 60 minutes, according to Accreditation Canada standards.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">FSC Results Requiring Urgent Medical Action<\/div>\n <p><strong>Circulating blasts + pancytopenia (low Hb + neutropenia + thrombocytopenia)<\/strong> \u2192 possible acute leukemia \u2192 urgent same-day hematology referral - don't wait.<\/p>\n <p><strong>Thrombocytopenia <20 G\/L + schistocytes on smear + hemolytic anemia<\/strong> \u2192 MAT (TTP or SHU) \u2192 immediate medical emergencies \u2192 plasma exchange in specialized hospital setting.<\/p>\n <p><strong>Severe neutropenia <0.5 G\/L + fever \u226538.3 \u00b0C<\/strong> \u2192 febrile neutropenia \u2192 medical emergencies \u2192 blood cultures + broad-spectrum IV antibiotic therapy without delay.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins de Clinique Omicron prescrivent et interpr\u00e8tent la formule sanguine compl\u00e8te dans le cadre des bilans de sant\u00e9, du suivi des maladies chroniques et de l'investigation de sympt\u00f4mes. Les anomalies n\u00e9cessitant un bilan sp\u00e9cialis\u00e9 (h\u00e9matologue, gastroent\u00e9rologue, gyn\u00e9cologue) font l'objet d'une orientation rapide. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et via la t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, <a href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\" data-oc-cta=\"fiche-consulter\">choisissez votre service en ligne<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is for informational purposes only and does not replace a doctor's interpretation. An abnormal complete blood count should always be interpreted in the overall clinical context of the patient.<\/p>\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Formule sanguine compl\u00e8te (FSC) : valeurs normales et interpr\u00e9tation | Clinique Omicron M\u00e9decine de laboratoire & H\u00e9matologie & M\u00e9decine de famille Formule sanguine compl\u00e8te (FSC) La formule sanguine compl\u00e8te (FSC) \u2014 \u00e9galement d\u00e9sign\u00e9e num\u00e9ration formule sanguine (NFS) ou h\u00e9mogramme \u2014 est l’analyse de sang la plus prescrite en m\u00e9decine clinique. Elle fournit une quantification automatis\u00e9e… <a href=\"https:\/\/cliniqueomicron.ca\/en\/formule-sanguine\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Complete blood count (CBC): normal values and interpretation | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Formule sanguine compl\u00e8te (FSC) : | Brossard | Clinique Omicron","_metasync_otto_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquett...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Formule sanguine compl\u00e8te (FSC) : | Brossard | Clinique Omicron","_metasync_otto_og_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquett...","_metasync_otto_twitter_title":"Formule sanguine compl\u00e8te (FSC) | Clinique Omicron","_metasync_otto_twitter_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquett...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Formule sanguine compl\u00e8te (FSC) : valeurs normales et interpr\u00e9tation | Clinique Omicron","_aioseo_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquettes au Qu\u00e9bec.","_metasync_seo_title":"Formule sanguine compl\u00e8te (FSC) : lire vos r\u00e9sultats | Omicron","_metasync_seo_desc":"La formule sanguine compl\u00e8te (FSC) est l\u2019examen de base du sang. 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\n\t\t\t\t\t\n\n\n\n\nComplete blood count (CBC): normal values and interpretation | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"The complete blood count (CBC) is the basic hematological examination. 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Un professionnel peut aussi interpr\u00e9ter vos r\u00e9sultats avec vous.<\/p><div class=\"oc-fiche-cta-b\"><a class=\"oc-p\" href=\"https:\/\/cliniqueomicron.ca\/prelevements-medicaux\/\">Blood sampling<\/a><a class=\"oc-s\" href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\">Make an appointment<\/a><a class=\"oc-s\" href=\"tel:+15146063350\">514 606-3350<\/a><\/div><\/div>\n\n\n <div class=\"co-intro\">\n The complete blood count (CBC) - also known as the complete blood count (CBC) or hemogram - is the most widely prescribed blood test in clinical medicine. It provides automated quantification of the three cell lineages of peripheral blood (red blood cells or erythrocytes, white blood cells or leukocytes, and platelets or thrombocytes) and their derived parameters, and is the essential baseline assessment for the vast majority of clinical situations: annual health check-up, investigation of fatigue or weight loss, preoperative assessment, chemotherapy monitoring, investigation of infection or inflammation, screening for hemopathy. In Quebec, FSC is performed on a venous blood sample taken in an EDTA tube (purple or lavender cap) and analyzed by a hematology analyzer such as Sysmex, Beckman Coulter DxH or Abbott CELL-DYN, which simultaneously measures all parameters by electrical impedance (Coulter method) and laser diffraction. When the automated system detects morphological anomalies or critical values (alarms), a peripheral blood smear is taken manually by a technician or hematologist to confirm and clarify the anomalies. The standard FSC includes erythrocyte parameters (hemoglobin, hematocrit, erythrocyte count, VGM, TGMH, CGMH, IDR), leukocyte parameters (total leukocyte count and differential formula: neutrophils, lymphocytes, monocytes, eosinophils, basophils) and platelet parameters (platelet count, mean platelet volume - MPV). Clinical interpretation of FSC must always be integrated into the clinical context, and can never replace clinical examination - a value slightly outside the reference range may be normal for a given individual, and a value within the limits may mask significant pathology.\n <\/div>\n\n <h2>Reference Values and Erythrocyte Parameters<\/h2>\n <ul class=\"co-list\">\n <li><strong>Erythrocyte parameters - normal adult values:<\/strong> hemoglobin (Hb): female 120-160 g\/L + male 130-175 g\/L - the parameter most commonly used clinically to define anemia (WHO: Hb <120 g\/L female + <130 g\/L adult male); hematocrit (Ht): female 0.36-0.46 + male 0.40-0.52 - volume proportion of erythrocytes in whole blood; erythrocyte count (RBC): female 3.8-5.2 \u00d7 10\u00b9\u00b2\/L + male 4.5-5.9 \u00d7 10\u00b9\u00b2\/L; mean corpuscular volume (MGV): 80-100 fL - key parameter for classification of anemias (microcytic 100 fL); mean globular hemoglobin content (TGMH): 27-33 pg - amount of Hb per erythrocyte - low in martial deficiency + thalassemia (hypochromia); mean globular hemoglobin concentration (CGMH): 320-360 g\/L - degree of erythrocyte hemoglobin saturation - low in martial deficiency (hypochromia) + very high in hereditary spherocytosis (>360 g\/L); erythrocyte distribution index (RDI or RDW): 11.5-14.5 % - measure of erythrocyte size heterogeneity (anisocytosis) - high in martial deficiency + myelodysplastic syndromes + hemolytic anemia - normal in thalassemia minor (homogeneous microcytosis) - very useful to distinguish martial deficiency (high RDW) vs. thalassemia minor (normal RDW) in microcytosis ; reticulocytes (often requested separately but are part of the extended FSC): normal value 20-100 \u00d7 10\u2079\/L (or 0.5-2.5 %) - high reticulocytes = regenerative anemia (hemolysis + acute hemorrhage + regeneration after treated deficiency) - low or normal reticulocytes in anemia = aregenerative anemia (central = aplasia + bone marrow invasion + deficiency)<\/li>\n <li><strong>Leukocyte parameters \u2014 normal adult values:<\/strong> total leukocytes: 4.0-10.0 \u00d7 10\u2079\/L - leukopenia 10.0 G\/L; leukocyte differential formula - normal values (adult): neutrophils (PNN): 1.8-7.5 \u00d7 10\u2079\/L (50-70 % of leukocytes) - severe neutropenia <0.5 G\/L = major infectious risk + moderate neutropenia 0.5-1.0 G\/L + mild 1.0-1.8 G\/L; lymphocytes: 1.0-4.8 \u00d7 10\u2079\/L (20-40 %) - lymphopenia 4.8 G\/L (viral infections + CLL + lymphoma); monocytes: 0.2-1.0 \u00d7 10\u2079\/L (2-8 %) - monocytosis in chronic infections + CMML (chronic myelomonocytic leukemia); eosinophils: 0.05-0.5 \u00d7 10\u2079\/L (1-5 %) - hypereosinophilia >0.5 G\/L: parasitoses + allergies + drugs + clonal hypereosinophilia (FIP1L1-PDGFRA); basophils: 0.01-0.10 \u00d7 10\u2079\/L (<1 %) - basophilia in CML + polycythemia vera + mastocytosis; physiological and ethnic variants of leukocyte count: benign ethnic neutropenia (formerly benign neutropenia of Afro-descendants): neutrophils 1.0-1.8 G\/L in individuals of African or Yemeni descent without pathology - linked to a polymorphism of the DARC gene (Duffy antigen) - no increase in infectious risk - important to know to avoid unnecessary investigations<\/li>\n <li><strong>Platelet parameters - adult normal values:<\/strong> platelet count: 150-400 \u00d7 10\u2079\/L - thrombocytopenia <150 G\/L (mild 100-150 + moderate 50-100 + severe 450 G\/L (reactive vs. clonal); mean platelet volume (MPV or MPV): 7-12 fL - high MPV = young, large platelets (peripheral destruction - ITP + TTP) + low MPV = reduced production (aplasia + chemotherapy); EDTA platelet aggregates: EDTA-dependent false thrombocytopenia (anti-platelet antibodies agglutinate in presence of EDTA) \u2192 confirm on citrate tube \u2192 normal result on citrate confirms pseudo-thrombocytopenia - to be systematically evoked in the presence of any isolated asymptomatic thrombocytopenia without suggestive clinical context; pre-analytical - conditions sampling on FSC quality: difficult sampling with hemolysis (falsely low Hb + falsely high CGMH) + coagulated sampling (unusable results) + delay between sampling and analysis >4h at room temperature (morphological changes in leukocytes + platelet degranulation) + storage at 100 G\/L (interference on Hb measurement by turbidity)<\/li>\n <\/ul>\n\n <h2>Interpretation of CBC anomalies<\/h2>\n <table class=\"co-table\">\n <colgroup><col style=\"width:200px;\"><col style=\"width:42%;\"><col><\/colgroup>\n <thead>\n <tr><th>FSC anomaly<\/th><th>Main causes and diagnostic orientation<\/th><th>Follow-up assessment and management<\/th><\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Hypochromic microcytic anemia<br><small style=\"font-weight:400;color:#7a8fa0;\">VGM <80 fL + low TGMH<\/small><\/td>\n <td>Hypochromic microcytic anemia is the most common form of anemia in general practice - its two main causes are martial deficiency and thalassemia minor, which require precise clinical and biological distinction as their treatments are radically different; martial deficiency (iron deficiency): most frequent cause of anemia worldwide - microcytosis + hypochromia + high IDR (>14.5 %) + marked anisocytosis on smear - causes: chronic blood loss (menorrhagia + digestive occult rectorrhagia + intravascular haemolysis) + inadequate intakes (strict veganism + malnutrition) + malabsorption (celiac disease + gastrectomy + prolonged PPIs - PPIs reduce the gastric acidity required to reduce ferric iron to ferrous) - martial status : ferritin (reflection of iron stores - low <15 \u00b5g\/L in true deficiency - falsely normal or high in inflammatory states) + serum iron (low) + transferrin (high) + transferrin saturation coefficient - TSC (low <15 %) + saturation coefficient = serum iron \/ total binding capacity \u00d7 100; thalassemia minor (thalassemic trait): marked microcytosis + NORMAL IDR (homogeneous RBC population) + Mentzer ratio = GMV \/ number of RBCs: 13 = probable martial deficiency - normal or elevated ferritin - Hb electrophoresis: Hb A2 >3.5 % = \u03b2-thalassemia minor (Hb A2 normal in \u03b1-thalassemia - diagnosis by PCR in genetics) - no indication for iron supplementation; anemia of chronic\/inflammatory diseases: normocytic or slightly microcytic + elevated or normal ferritin + low iron + low transferrin (in contrast to martial deficiency) + elevated hepcidinemia - context: chronic inflammation + neoplasia + renal failure + autoimmune disease; lead intoxication: microcytosis + basophilic punctations on smear + elevated blood lead + occupational or environmental context<\/td>\n <td>1st-line workup for microcytic anemia: ferritin (most reliable parameter of iron stores) + serum iron + transferrin + CST + reticulocytes + peripheral blood smear; if ferritin is low (confirmed martial deficiency): search for cause: in women of childbearing age \u2192 menorrhagia (most frequent cause) \u2192 gynaecological work-up; in any adult without obvious cause \u2192 occulted rectal bleeding \u2192 digestive work-up (FIT - faecal immunological test + colonoscopy if FIT positive or digestive symptoms) \u2192 search for celiac disease (anti-transglutaminase IgA + total IgA antibodies) ; if normal or elevated ferritin + microcytosis + normal IDR \u2192 Hb electrophoresis \u2192 thalassemia; treatment of martial deficiency: ferrous iron PO (ferrous fumarate + ferrous gluconate + ferrous sulfate 150-200 mg elemental iron\/d fasting or 1h before meal) - increase in reticulocytosis in 7-10d (response criterion) + Hb normalization in 4-8 weeks + treatment for 3-6 months after Hb normalization to replenish reserves (ferritin >50 \u00b5g\/L); IV iron (ferric carboxymaltose - Ferinject + iron sucrose - Venofer): indicated if digestive intolerance to oral iron + malabsorption + severe symptomatic deficiency (Hb <90 g\/L) + chronic renal failure on EPO + 2nd-3rd trimester pregnancy + refusal of oral iron - superior efficacy to oral iron in terms of rapid correction of ferritin; monitoring under treatment: CBC + ferritin at 4-6 weeks (expected response) + at 3 months (Hb normalization)<\/td>\n <\/tr>\n <tr>\n <td>Macrocytic anemia<br><small style=\"font-weight:400;color:#7a8fa0;\">VGM >100 fL<\/small><\/td>\n <td>Macrocytic anemia groups together two mechanistically distinct major categories: megaloblastic macrocytosis (DNA synthesis abnormality due to vitamin B12 or folate deficiency) and non-megaloblastic macrocytosis (various causes without DNA synthesis abnormality); megaloblastic macrocytosis - vitamin B12 (cobalamin) deficiency: VGM often >110-120 fL + macro-ovalocytes + hypersegmentation of neutrophils (\u22655 lobes in >5 % of PNN = highly specific criterion) + anemia + pancytopenia possible in severe forms - specific neurological manifestations absent in folate deficiency: peripheral neuropathy (lower limb paresthesias + ataxia) + subacute combined degeneration of the spinal cord (posterior cord + spinocerebellar involvement) - causes: malabsorption (autoimmune atrophic gastritis = Biermer's anemia - antiintrinsic factor + anti-parietal cell antibodies - the most frequent cause of symptomatic low B12) + gastrectomy + ileal Crohn's disease + ileal resection + strict veganism (absence of animal products) + Metformin (reduces ileal B12 absorption) + long-term PPIs; folate deficiency (folic acid = vitamin B9): morphology identical to B12 deficiency - absence of neurological impairment - causes : inadequate intake (alcoholism + anorexia + diet low in green vegetables) + malabsorption (celiac disease) + antifolate drugs (methotrexate + trimethoprim + phenytoin + sulfasalazine) + increased needs (pregnancy - folates are essential for neural tube closure - periconceptional supplementation 0.4-5 mg\/d depending on risk factors) + chronic hemolysis; non-megaloblastic macrocytosis - frequent causes: alcoholism (macrocytosis without anemia or morphological abnormality of the smear - direct mechanism on the erythrocyte membrane) + hypothyroidism + chronic liver disease + drugs (hydroxyurea + zidovudine + azathioprine + leflunomide) + myelodysplastic syndromes (MDS - macrocytosis + cytopenia + dysplasia on smear - myelogram mandatory) + bone marrow regeneration (reticulocytosis - reticulocytes larger than mature RBCs)<\/td>\n <td>1st-line workup for macrocytosis: VGM + blood smear (macro-ovalocytes + PNN hypersegmentation = megaloblastic) + serum B12 assay + erythrocyte folates (erythrocyte folates better reflect folic status than serum folates, which vary with recent intake) + TSH + GGT + liver workup + complete blood count (pancytopenia?) + reticulocytes; if low B12 : search for cause \u2192 antiintrinsic factor antibodies (specificity 95 % for Biermer if positive) + anti-parietal cell antibodies (sensitivity 80 % but less specific) + gastroscopy if Biermer suspicion (fundic biopsies - atrophic gastritis + metaplasia) + colonoscopy if digestive symptoms + urinary MMA assay + homocysteinemia (elevated in both B12 and folate deficiencies) - useful in case of borderline B12 values; treatment of B12 deficiency : oral B12 (cyanocobalamin 1,000 \u00b5g\/d PO - as effective as IM in most cases if no total malabsorption because a fraction of B12 is absorbed by passive diffusion independently of the intrinsic factor) + IM B12 (cyanocobalamin 1,000 \u00b5g IM\/d \u00d7 7d \u2192 weekly \u00d7 4 \u2192 monthly for life) - if Biermer or total malabsorption \u2192 IM or nasal for life; folate deficiency treatment: folic acid 1-5 mg\/d PO \u00d7 3-4 months + correction of cause - NEVER supplement with folates alone without excluding B12 deficiency (risk of masking the hematological manifestations of B12 deficiency while allowing irreversible neurological damage to progress); MDS: bone marrow work-up (myelogram + bone marrow biopsy + cytogenetics + NGS) + hematology referral.<\/td>\n <\/tr>\n <tr>\n <td>White blood cell abnormalities<br><small style=\"font-weight:400;color:#7a8fa0;\">Leukocytosis + leukopenia + differential count<\/small><\/td>\n <td>Leukocyte count abnormalities are frequent and their interpretation requires analysis of the complete differential formula and clinical context; neutrophilia (PNN >7.5 \u00d7 10\u2079\/L) : acute bacterial infection (most frequent - increased PNN + toxic granulations + D\u00f6hle bodies on smear in severe infections) + leukemoid reaction (PNN >30 G\/L with myelemia - severe infections + G- drugs.CSF + neoplastic soliditis) + corticosteroids (PNN demargination - rapid increase in PNN without infection) + smoking (moderate chronic neutrophilia) + physical stress (surgery + infarction) + pregnancy + polycythemia vera + chronic myeloid leukemia (CML - PNN >30 G\/L + myelemia + basophilia + spleno - BCR-ABL +) ; neutropenia (PNN 4.8 \u00d7 10\u2079\/L): acute viral infections (EBV + CMV + adenovirus - atypical lymphocytosis with large activated lymphocytes on smear) + pertussis (marked lymphocytosis in catarrhal phase - small mature lymphocytes) + CLL (persistent lymphocytosis + monoclonal + Gumprecht shadows on smear + CD19+CD5+ immunophenotyping mandatory) + leukemic non-Hodgkin's lymphoma; eosinophilia (>0.5 \u00d7 10\u2079\/L) : invasive tissue parasitoses (toxocariasis + filariasis + echinococcosis + hookworm - intraluminal parasites such as pinworms do not give hypereosinophilia) + allergies + asthma + drugs (DRESS) + Churg-Strauss disease (EGPA) + hypereosinophilic syndrome (FIP1L1-PDGFRA if >1.5 G\/L persistent \u2192 imatinib) + T lymphoma; monocytosis (>1.0 \u00d7 10\u2079\/L) : chronic infections (tuberculosis + brucellosis + endocarditis + leishmaniasis) + CMML (chronic myelomonocytic leukemia - persistent monocytes >1 G\/L + dysplasia + myelogram).<\/td>\n <td>Diagnostic approach to leukocyte abnormalities: moderate leukocytosis (10-30 G\/L) in obvious infectious or inflammatory context \u2192 no immediate further investigation + treatment of cause + FSC check at 4-6 weeks after resolution of context; persistent unexplained leukocytosis >12-15 G\/L or >30 G\/L \u2192 blood smear mandatory \u2192 if myelemia (promyelocytes + myelocytes + metamyelocytes) + basophilia \u2192 CML \u2192 BCR-ABL by PCR or FISH \u2192 urgent hematology; persistent lymphocytosis >5 G\/L in adults >45 years \u2192 lymphocyte immunophenotyping (flow cytometry) \u2192 LLC exclusion \u2192 if LLC confirmed (CD19+CD5+CD23+ + kappa or lambda restriction) \u2192 Binet classification \u2192 hematology reference ; isolated neutropenia \u2192 complete drug review \u2192 follow-up CBC at 3-4 weeks after discontinuation of suspect drug \u2192 if persistent \u2192 ANA + B12 + folates + HIV serology + ANCA \u2192 if unexplained \u2192 myelogram + hematology consultation; fever + neutropenia (1.5 G\/L \u2192 parasite workup (serologies + coproparasitology \u00d7 3) + ANA + ANCA + mast cell tryptase + BCR-ABL + FIP1L1-PDGFRA + myelogram \u2192 referral to internal medicine or hematology<\/td>\n <\/tr>\n <tr>\n <td>Platelet abnormalities<br><small style=\"font-weight:400;color:#7a8fa0;\">Thrombocytopenia + thrombocytosis<\/small><\/td>\n <td>Platelet abnormalities are frequent at FSC and require a rigorous diagnostic approach taking into account the level of thrombocytopenia and the clinical context; thrombocytopenia <150 G\/L - approach by mechanism: false EDTA-dependent thrombocytopenia (pseudo-thrombocytopenia) : always exclude in 1st intention - confirm by sampling on citrate or heparin tube + call laboratory to check platelet aggregates on smear - accounts for 15-30 % of incidental thrombocytopenia discovered on routine workup; thrombocytopenia due to peripheral destruction (regenerative - high MPV - normal reticulocytes): IPT (primary immunological thrombocytopenia): isolated thrombocytopenia <100 G\/L + normal smear + exclusion of secondary causes - anti-platelet antibodies (low sensitivity + specificity - not recommended routinely) - diagnosis of exclusion - treatment if platelets 0.1 % + ADAMTS13 450 G\/L: reactive (most frequent): martial deficiency + infection + inflammation + post-splenectomy + solid cancer + corticosteroids - benign + treatment of cause; essential (clonal): essential thrombocythemia (ET): persistent thrombocytosis >450 G\/L + JAK2 V617F mutation (in 55 % of ETs) + CALR mutation (25 %) + MPL (5 %) \u2192 myelogram + molecular biology \u2192 hematology \u2192 thrombotic + hemorrhagic risk<\/td>\n <td>Clinical thresholds for thrombocytopenia and practical steps to be taken: thrombocytopenia 100-150 G\/L: generally asymptomatic - FSC check-up at 4-8 weeks + verification of pseudothrombocytopenia + drug history + HIV serology + TSH + ANA if suggestive context; thrombocytopenia 50-100 G\/L : mild to moderate bleeding risk - minor surgery possible if >80 G\/L - avoid NSAIDs + aspirin + anticoagulants - active etiological investigation mandatory - refer to haematology if cause not obvious; thrombocytopenia <50 G\/L : significant bleeding risk - contraindication to lumbar punctures + deep biopsies without prior platelet transfusion if <50 G\/L - contraindication to elective surgery if <50 G\/L - hospitalization if <20 G\/L or active bleeding; thrombocytopenia <20 G\/L without obvious cause \u2192 hospitalization + urgent investigation + hematology referral; platelet transfusion: prophylactic threshold (without bleeding): platelets <10 G\/L in the context of drug-induced aplasia + <20 G\/L if fever or invasive procedure planned + <50 G\/L before non-neurosurgical surgery + 50 % or platelets <100 G\/L \u2192 score 4Ts \u2192 discontinue heparin if HIT suspected + switch non-heparin anticoagulant<\/td>\n <\/tr>\n <tr>\n <td>Polyglobulia and polycythemia<br><small style=\"font-weight:400;color:#7a8fa0;\">High hemoglobin and hematocrit<\/small><\/td>\n <td>Elevated hemoglobin and hematocrit may reflect a true increase in erythrocyte mass (polyglobulia vera) or a decrease in plasma volume (relative polyglobulia or pseudo-polyglobulia); relative polyglobulia (pseudo-polyglobulia): Hb and Ht elevated by hemoconcentration without increase in erythrocyte mass - causes: severe dehydration + diuretics + profuse vomiting + extensive burns + Gaisbock syndrome (obese man + hypertension + smoker + stress) - treatment: correction of cause + hydration; true polyglobulia - definition: Hb >185 g\/L in men + >165 g\/L in women (WHO 2022) OR hematocrit >52 % in men + >48 % in women - classification: secondary polyglobulia (appropriate - chronic hypoxia \u2192 EPO increase \u2192 compensatory polyglobulia) : COPD + sleep apnea + altitude + smoking + cyanogenic heart disease + high-affinity hemoglobin - serum EPO dosage (high) + O\u2082 saturation (low if respiratory cause) + PSG if apneas suspected; inappropriate polyglobulia (ectopic EPO secretion): renal cell carcinoma + hemangioblastoma + hepatocarcinoma + uterine fibroids - elevated serum EPO + abdominal imaging; polycythemia vera (PV - clonal myeloproliferative disease): high Hb + Ht + leukocytosis + thrombocytosis + splenomegaly + aquagenic pruritus (pathognomonic) + low EPO + JAK2 V617F mutation (present in 95 % of PV) - major thrombotic risk (stroke + MI + portal vein thrombosis) + risk of transformation into myelofibrosis or AML - treatment: bloodletting (phlebotomy) to maintain Ht <45 % + aspirin 100 mg\/d + hydroxyurea (if high risk) + ruxolitinib (anti-JAK2 - if resistance or intolerance to hydroxyurea)<\/td>\n <td>Approach to polycythemia on FSC: step 1: check preanalytical conditions (prolonged tourniquet \u2192 pseudo-increased Ht) + exclude dehydration + repeat FSC on fresh sample if in doubt; step 2: if Hb >165 g\/L woman or >185 g\/L man persists \u2192 serum EPO assay + O\u2082 saturation (SpO\u2082 rest + effort) + search for JAK2 V617F mutation by PCR; interpretation: JAK2 V617F positive \u2192 polycythemia vera \u2192 myelogram + osteo-medullary biopsy + thrombotic workup \u2192 emergency hematology; JAK2 negative + EPO low \u2192 other myeloproliferative mutation (exon 12 JAK2 + CALR + MPL) \u2192 myelogram; high EPO + low SpO\u2082 \u2192 secondary respiratory polyglobulia \u2192 spirometry + PSG + chest CT + ECG; high EPO + normal SpO\u2082 \u2192 ectopic polyglobulia \u2192 abdomino-pelvic CT (renal carcinoma ++) + abdominal ultrasound; emergency treatment if severe symptomatic polyglobulia (Ht >55 % + signs of hyperviscosity: headache + flush + dizziness + tinnitus + erythromelalgia): phlebotomy (150-450 mL) + hydration \u2192 hematology<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2139\ufe0f<\/span>\n <span><strong>FSC Critical Values \u2014 Laboratory Alert Thresholds:<\/strong> Quebec laboratories (according to Accreditation Canada + LSPQ standards) automatically transmit the following critical values to the prescribing physician without delay: hemoglobin 200 g\/L \u2014 leukocytes 30 G\/L \u2014 platelets 1,000 G\/L \u2014 presence of circulating blasts. These values require immediate clinical re-evaluation and medical action within a defined timeframe (critical values protocol). A critical result received by the laboratory must be communicated to the physician or responsible nurse within a maximum of 60 minutes, according to Accreditation Canada standards.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">FSC Results Requiring Urgent Medical Action<\/div>\n <p><strong>Circulating blasts + pancytopenia (low Hb + neutropenia + thrombocytopenia)<\/strong> \u2192 possible acute leukemia \u2192 urgent same-day hematology referral - don't wait.<\/p>\n <p><strong>Thrombocytopenia <20 G\/L + schistocytes on smear + hemolytic anemia<\/strong> \u2192 MAT (TTP or SHU) \u2192 immediate medical emergencies \u2192 plasma exchange in specialized hospital setting.<\/p>\n <p><strong>Severe neutropenia <0.5 G\/L + fever \u226538.3 \u00b0C<\/strong> \u2192 febrile neutropenia \u2192 medical emergencies \u2192 blood cultures + broad-spectrum IV antibiotic therapy without delay.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins de Clinique Omicron prescrivent et interpr\u00e8tent la formule sanguine compl\u00e8te dans le cadre des bilans de sant\u00e9, du suivi des maladies chroniques et de l'investigation de sympt\u00f4mes. Les anomalies n\u00e9cessitant un bilan sp\u00e9cialis\u00e9 (h\u00e9matologue, gastroent\u00e9rologue, gyn\u00e9cologue) font l'objet d'une orientation rapide. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et via la t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, <a href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\" data-oc-cta=\"fiche-consulter\">choisissez votre service en ligne<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is for informational purposes only and does not replace a doctor's interpretation. An abnormal complete blood count should always be interpreted in the overall clinical context of the patient.<\/p>\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Formule sanguine compl\u00e8te (FSC) : valeurs normales et interpr\u00e9tation | Clinique Omicron M\u00e9decine de laboratoire & H\u00e9matologie & M\u00e9decine de famille Formule sanguine compl\u00e8te (FSC) La formule sanguine compl\u00e8te (FSC) \u2014 \u00e9galement d\u00e9sign\u00e9e num\u00e9ration formule sanguine (NFS) ou h\u00e9mogramme \u2014 est l’analyse de sang la plus prescrite en m\u00e9decine clinique. Elle fournit une quantification automatis\u00e9e… <a href=\"https:\/\/cliniqueomicron.ca\/en\/formule-sanguine\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Complete blood count (CBC): normal values and interpretation | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Formule sanguine compl\u00e8te (FSC) : | Brossard | Clinique Omicron","_metasync_otto_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquett...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Formule sanguine compl\u00e8te (FSC) : | Brossard | Clinique Omicron","_metasync_otto_og_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquett...","_metasync_otto_twitter_title":"Formule sanguine compl\u00e8te (FSC) | Clinique Omicron","_metasync_otto_twitter_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquett...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Formule sanguine compl\u00e8te (FSC) : valeurs normales et interpr\u00e9tation | Clinique Omicron","_aioseo_description":"La formule sanguine compl\u00e8te (FSC) est l'examen h\u00e9matologique de base. Valeurs normales, interpr\u00e9tation des anomalies des globules rouges, blancs et plaquettes au Qu\u00e9bec.","_metasync_seo_title":"Formule sanguine compl\u00e8te (FSC) : lire vos r\u00e9sultats | Omicron","_metasync_seo_desc":"La formule sanguine compl\u00e8te (FSC) est l\u2019examen de base du sang. 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