A situation often happens when the result of a general blood test of a child is in their hands, and the parents simply do not understand the meanings. Of course, for an accurate explanation of blood counts, a specialist consultation is necessary. But so that parents do not worry and have an idea of the meaning and level of blood counts in the analysis, this article has been written. Deciphering a blood test in children is important for characterizing the pathological processes that occur in the body.
Complete blood count in children
A general blood test is a procedure that everyone has undergone more than once in their life. This diagnostic method consists in taking blood from the subject's finger. Further, the biological material (blood) is subject to a more accurate study under a microscope.
Deciphering a blood test in children, a table of age norms - all these data can be observed in modern analysis results. Some laboratories highlight indicators with arrows that are outside the normal range. But the consultation of a specialist after the analysis is always necessary.
When is it appointed?
There are certain indications for the appointment of a general blood test:
- preventive examination;
- in cases where the child is registered with a dispensary;
- monitoring of the therapy that is given to the child;
- assistance to a specialist in making an accurate diagnosis.
Preparing children of different ages for analysis
A general blood test in children is carried out in the morning.
The procedure is performed on an empty stomach.
It is forbidden to eat before taking blood. And also the last meal should be at least 8 hours apart. In the morning, you can only drink water. But for babies it is difficult to withstand such a break. Therefore, blood is drawn between feedings. Before the planned donation of blood, it is recommended to stop taking medicinal substances, but this is decided strictly with your specialist. It is advisable to stop physical activity and active games one day before the examination, as this may affect the result.
Immediately before entering the treatment room, you need to make sure that your child has warm hands. Since blood collection is difficult due to cold hands. Also, an important point is the emotional calmness of the mother and child. Before the procedure, the child needs to be calm and prepared. Otherwise, it will be difficult to draw blood.
How is blood drawn?
As mentioned above, a general blood test is performed by taking biological material from a finger. In this case, capillary blood is needed. If there is a need for a biochemical blood test or coagulogram, then blood is taken from a vein (venous). The healthcare professional wipes the pad of the finger with a cotton swab moistened with alcohol or antiseptic.
Most often, the ring finger is used, because the skin on it is softer, in this regard, the puncture is easier to make, and it will be painless. Also, the ring finger is less involved in any activity. If blood sampling from the ring finger is not possible, then it is carried out from the middle or index finger. This point is important because these fingers have the lowest risk of infection in the hand, compared to the thumb and little finger.
After selecting the right finger, the healthcare professional proceeds to the puncture. In older children, he performs this manipulation using a special needle. And for babies, it uses a scarifier, such a device has a very thin needle that easily pierces the delicate skin and does not hurt the child.
The laboratory assistant removes the first drop of blood with cotton wool moistened with an antiseptic solution. And the blood that came next is taken by a capillary and transferred to a sterile test tube. After completing the procedure, the medical professional applies clean cotton wool soaked in antiseptic to the puncture site and squeezes the handle into a fist. In this position, you should hold your hand to stop the blood faster.
Standard indicators of a complete blood count, determined in children
First of all, when a specialist picks up the results of the analysis, attention is paid to the main blood parameters, which will be described below. Changes in these data indicate that the child is not well.
Erythrocytes and hemoglobin
Red blood cells (RBC) are a red blood cell made of proteins (hemoglobin). In newborns, erythrocytosis is observed on the first day (the level of erythrocytes ranges from 4.0 to 6.5 x 10 ^ 12 cells / l), most of the erythrocytes are reticulocytes (young erythrocytes). In this regard, the skin of newborns is red. Further, every day the level of erythrocytes decreases and by the month of the baby's life it is already 3.0 - 5.5 x 10 ^ 12 cells / l. At the age of 12, erythrocytes reach a concentration of 3.5 - 5.5 x 10 ^ 12 cells / l and no longer differ from the adult norm.
Hemoglobin (HGB) is a protein found in red blood cells (erythrocytes). The main function of hemoglobin is respiration of cells and tissues, as well as transportation of gases. The hemoglobin level indicates oxygen saturation in the blood. For men, its normal concentration corresponds to the value - 130 - 160 g / l, for women - 120 - 140 g / l.
And in children, the level changes with age. So, for example, newborn babies have hemoglobin above 150 g / l, due to the increased concentration of red blood cells. At the age of 6 years, hemoglobin can fall to 110 g / l and this is not a pathology. Children over 6 years of age should have hemoglobin above 120 g / l.
Leukocyte formula
White blood cells (WBC) are the cellular constituents of white blood, the task of which is to protect the body from infectious diseases. Leukocytes are involved in the recognition and removal of pathogenic substances. The concentration of white blood cells also changes with the age of the child.
In newborns, the normal value of the indicator is from 8.0 to 24.0 x 10 ^ 9 cells / l. By the month of life, the level drops to 6.5 - 13.0 x 10 ^ 9 cells / l. In a year, the upper limit decreases to 12 x 10 ^ 9 cells / l, and at the age of 8 years, the concentration of leukocytes reaches the normal level of an adult (4.2 - 9.4 x 10 ^ 9 cells / l). Leukocytes are divided into different types. Depending on which types of cells prevail in percentage terms, a picture of the etiology of the disease is built. Various ratios of leukocytes make up the leukocyte formula.
In a healthy adult, neutrophils should predominate over lymphocytes. And in children, priorities can change and this is not a pathology. Until the first 5 days of a child's life, an increased level of neutrophils is observed in the blood, while lymphocytes are at a lower concentration. At the age of 5 - 7 days, an equal value of these indicators is observed. Then, up to 5 years, the level of neutrophils falls, and the level of lymphocytes rises. And at the age of 4 - 6 years, the indicators also become equal.
One should not forget about this physiological process, since, without knowing this fact, a general blood test can be interpreted incorrectly.
Platelets
Platelets (PLT) are non-nucleated blood platelets. The normal platelet count practically does not depend on the child's age and ranges from 200 to 400 • 10 ^ 9 cells / l. The life cycle of a platelet ranges from 1 to 14 days, with an average of 7 days. The function of such cells is to nourish the vessels, as well as to prevent blood loss when the vessels are injured. Hemostasis (blood clotting) is the main process in which platelets are involved.
ESR
The erythrocyte sedimentation rate (ESR) is the time during which the sedimentation of red blood cells is observed under the influence of gravity. Normally, the density of the formed elements is higher than the plasma, so such a reaction can be observed. Erythrocytes stick together to form a denser mass. Normally, this figure is 1 - 14 mm / hour. By the rate of erythrocyte sedimentation, one can judge the pathological process.
Additional indicators
In the general analysis, there are other indicators that are also important in assessing the condition of the child and making a diagnosis.
Hematocrit (Ht, HCT) - an indicator that, in percentage terms, reflects the proportion of erythrocytes in the total blood volume. In newborns, this indicator is higher, since the concentration of erythrocytes is also higher, it is 44 - 62%. With age, the hematocrit decreases. In childhood, there is a uniform rate of 35 - 45%. In adults, there are some differences depending on gender. Women have normal values from 36 to 47%, and men - 40 - 54%.
To diagnose anemia, there are erythrocyte indices MCV, MCH, MCHC... Such indicators allow you to assess the desired characteristics of the erythrocyte. MCV is the average erythrocyte volume. It is a quantitative indicator that changes in femtoliters.
Age periods in childhood change the rates of the indicator. At 1 month of life in a child, the average volume of erythrocytes is 85 - 115 fl. Children over 6 months have a normal value of 70 to 85 fl, and over 6 years old - 75 to 85 fl.
Such changes are of great clinical importance. So, for example, microcytosis (low rate) is observed in iron deficiency anemia, vitamin B6-dependent anemia, thalassemia. With leukemia, anemia can be both normocytic and macrocytic. Macrocytosis (high) can also be detected with B12 and folate deficiency anemias, hormonal disorders (hypothyroidism), liver disease, smoking, alcoholism.
MCH - clearly shows the average hemoglobin content inside the erythrocyte. This indicator can be calculated independently, knowing the values of hemoglobin and erythrocytes. A similar indicator is MCHC - indicates the concentration of hemoglobin in erythrocytes in the average value. Calculated in terms of the ratio of hemoglobin to hematocrit. Such indicators are important in the diagnosis of anemia.
Deviations from the norm in the general blood test in children
According to the results of indicators in a general blood test, the doctor can determine the pathological process, and also suggest a diagnosis.
Erythrocytes
Erythrocytosis (an increase in the concentration of red cells) can be both a primary pathology and a secondary one. The primary process is a condition that occurs with the pathology of the blood system itself. An increase in the number of erythrocytes is observed with leukemia, Waxza's disease. Secondary erythrocytosis occurs against the background of the pathology of other organs and systems, as well as in some pathological conditions.
An increase in the concentration of red blood cells is possible in many diseases of vital organs, neoplasms, hormonal disorders (Cushing's syndrome). Treatment with certain drugs (steroids, diuretics) also increases the level of red blood cells. Hypoxic conditions reduce the concentration of oxygen in the blood, and, consequently, of erythrocytes and hemoglobin.
Some pathological reactions can cause blood clots, which also increase the number of red blood cells. Thermal lesions of the skin, stool disturbance, and vomiting contribute to changes in the rheological properties of blood. The opposite situation (with a decrease in the number of erythrocytes) is observed in almost all types of anemias. It is logical to believe that blood loss also contributes to a decrease in the concentration of red blood cells along with hemoglobin.
One of the physiological processes that occurs in pregnant women is a slight decrease in the number of red blood cells. If we analyze the primary reason for the decrease in the concentration of red blood cells, then in this situation there is a decrease in the production of the cells themselves in the bone marrow. Or it could be an acceleration of the destruction of red blood cells and a decrease in the life of cells.
The average duration of erythrocyte circulation in the blood is 120 days.
Hemoglobin
The reasons for the change in the concentration of hemoglobin in the blood are directly related to the level of the number of erythrocytes. More often, an increase in hemoglobin is observed with dehydration, that is, dehydration of the body, bad habits (smoking). A decrease, just like in erythrocytes, is recorded with anemia.
Leukocytes
A leukocyte concentration of less than 4 x 10 ^ 9 cells / L is considered leukopenia. Leukopenia is more often observed with various viral infections. Systemic autoimmune diseases also contribute to a decrease in white blood cell count. The drugs that the patient takes during the period of exacerbation of the disease increase leukopenia.
Diseases of the blood, namely megaloblastic anemia, certain stages of leukemia, also lead to a decrease in leukocytes, thereby depriving the child of protection from infections. An enlarged spleen reduces the number of leukocytes in the general blood test. General depletion of the body also leads to this result.
An increase in the number of leukocytes (leukocytes) can be disassembled in two different situations. Leukocytosis can be physiological, that is, it does not require treatment and is normal and pathological. Physiological changes include leukocytosis during food intake, so it is important to take an analysis on an empty stomach. Also, leukocytes can increase during pain, stress, cold.
Pathological conditions - those situations in which there is an increase in leukocytes of more than 15 • 10 ^ 9 require attention and appropriate medical care. More often in children, such leukocytosis is recorded in inflammatory processes, acute bacterial and herpes infections. Emergencies such as shock, bleeding, trauma cause an increase in the concentration of white blood cells. Some malignant tumors lead to leukocytosis.
Neutrophils
The process of increasing neutrophils is called neutrophilia or neutrophilia. Such changes are observed in bacterial infections, inflammatory processes. It is also possible to increase neutrophils after surgery. The opposite situation (neutropenia) is detected in some somatic and infectious diseases. But it is important to understand that neutropenia can exist as an independent disease.
This condition has its own clinical manifestations:
- constantly recurring bacterial infections that cause otitis media, paroproctitis, lymphadenitis, paronychia;
- damage to the mucous membranes (stomatitis, gingivitis);
- fever without a visible focus of infection.
To make a diagnosis, you need to know the fluctuations from the norm. For children over one year old, it is important to reduce the absolute number of neutrophils (segmented and stab neutrophils) to 1500 cells / μL. Up to a year, neutropenia is clinically significant with a decrease in elements to 1000 cells / μL and below. The severity of the disease is also distinguished. Moderate neutropenia is determined when the number of neutrophils is 0.5 - 1 • 10 ^ 9, severe - 0.2 - 0.5 • 10 ^ 9, very severe is recorded if neutrophils decrease less than 0.2 • 10 ^ 9 cells / μl.
Eosinophils
Normal values of cells that are involved in anthelmintic immunity are 0.5 - 5%. First of all, if eosinophilia is observed, it is necessary to exclude the presence of parasites. In addition, an increase in eosinophils is observed in various allergic conditions, diseases of the skin. Infections that are most common in childhood, such as scarlet fever, chickenpox, infectious mononucleosis, can cause eosinophilia.
Late stages of tumor processes also lead to an increase in eosinophils. Also, eosinophilia is observed in diseases of the connective tissue and lungs (pleurisy, sarcoidosis).
Basophils
Basophils are the smallest group of leukocytes and are 0.5 - 1%. Basophilia (an increase in the number of cells) is recorded in allergic and autoimmune processes. Chickenpox often occurs with an increase in the number of basophilic group of leukocytes. Diseases in which this condition is also observed are chronic hemolytic anemia, inflammatory kidney disease, myeloid leukemia, ulcerative colitis, lymphoma.
Lymphocytes
Lymphocytes are cells that help protect the body from various infections. The amount normally ranges from 20 to 40%, but one should not forget about the physiological rises and falls in a certain childhood. Lymphocytosis (an increase in the number of cells) is observed in most infectious diseases, heavy metal poisoning. Systemic blood diseases (lymphomas, lympholeiosis) also lead to lymphocytosis.
Also, some medications (narcotic analgesics, valproic acid preparations) can affect the number of cells. A more severe condition is observed with lymphopenia (a decrease in the concentration of lymphocytes). In this situation, an immunodeficiency state develops.
Diseases that can lead to lymphopenia:
- tuberculosis;
- acute infections;
- lymphogranulomatosis;
- a condition in which there was a loss of lymph;
- systemic lupus erythematosus;
- the last stages of the oncological process;
- renal failure;
- primary or secondary immunodeficiencies;
- taking certain drugs (cytostatics, glucocorticosteroids).
Monocytes
Monocytes are the largest cells in all leukocytes and make up 2-10%. These cells are also involved in the formation of immunity. Therefore, various viral infections will serve as a reason for the increase in monocytes. And also such diseases as tuberculosis, syphilis, ulcerative colitis, blood diseases, malignant neoplasms.
Monocytopenia (a decrease in the level of monocytes in the blood) is observed with damage to the bone marrow, leukemia, taking medications (cytostatics, glucocorticosteroids). And also a decrease in monocytes is recorded in childbirth, during surgery.
Platelets
Thrombocytopenia (a decrease in the level of platelets) is recorded when the concentration of platelets decreases less than 150 x 10 ^ 9 cells / l. In children, thrombocytopenia is most often recorded during autoimmune thrombocytopenic purpura.
During the period of illness, active destruction of platelets occurs. Clinically, the disease manifests itself as multiple bruising and bruising on the skin, as well as bleeding. Also, a decrease in platelets is observed with a decrease in the formation of cells in the bone marrow with anemia or metastases to the organ itself.
Often, children after an intestinal bacterial infection may develop a serious condition - hemolytic uremic syndrome, which includes acute renal failure, hemolytic anemia and thrombocytopenia. Dysfunction of the thyroid gland also contributes to a decrease in platelets in the blood test. Medicines such as Aspirin, Biseptol, Analgin, Vincristine, Levomycetin affect the number of platelets.
Thrombocytosis (an increase in the number of platelets over 400 x 10 ^ 9 cells / l) accompanies more formidable diseases. More often in a number of such conditions, malignant neoplasms of various organs, leukemia, sepsis are recorded. And some surgical conditions - after removal of the spleen, after severe blood loss, surgery.
ESR
The erythrocyte sedimentation rate should not exceed 14 mm / h. What does ESR acceleration mean? First of all, it is necessary to assume the development of an inflammatory process or infection. Systemic connective tissue diseases, anemia, hemoblastosis, and liver disease can also increase the rate.
The erythrocyte sedimentation rate increases when the breakdown products of proteins or cells are released into the blood. In this case, such a mass, together with the shaped elements, will be much heavier than the plasma, and therefore, it will settle faster. ESR can also increase in connection with physiological processes. For example, during pregnancy, menstruation.
Parents are often interested in what kind of infection the child has, viral or bacterial? Indeed, the blood can suggest the etiology of this or that infection. When leukocytosis is more than 15 • 10 ^ 9 cells / l, neutrophilia is more than 10 • 10 ^ 9 cells / l, bacterial infection is most likely.
But these data are not enough, complements the diagnostic picture of C-reactive protein, which should be more than 70 mg / l and procalcitonin more than 2 ng / mg. But the last indicators are taken as needed from a vein. As for the viral infection, the situation is different. A high probability of viral etiology is observed if the ratio of the absolute number of lymphocytes to the absolute number of leukocytes is greater than or equal to the numerical value of 0.35.
Features of a general blood test depending on the age of the child
The laboratory has its own standards for each blood indicator. They certainly do not vary much. But you should always evaluate the standards that the laboratory describes. In modern results, next to each blood indicator of a child, normal limits are indicated.
But it is important to understand that the norms are not adjusted to the age of a particular patient. Therefore, it must be remembered that, for example, at the age of up to 5 years, lymphocytes and neutrophils change places as a percentage of each other. This physiological phenomenon is described in more detail above.
A special age, which differs significantly in the norms of blood counts, is the period of the newborn. It must be remembered that most cells are above normal (leukocytes, erythrocytes, platelets, hemoglobin). Such saturated blood is characterized by a compensatory response to hypoxia before childbirth and during birth. And also such blood contains a large number of young precursor cells, which then, if unnecessary, die.
What can cause the bias in the results?
As recommended above, do not eat before taking blood. Food intake can affect the number of leukocytes, they will be increased. Also, leukocytosis can be observed after physical exertion, emotional overstrain. Therefore, it is better to exclude these provoking factors. And if it is impossible, postpone blood donation, if this situation allows.
Medicines can affect the result of many blood parameters, therefore, after consulting a doctor, it is advisable to stop taking it for the period of the analysis. Girls during menstruation should inform the doctor about this, because the blood test result will be distorted and create a false picture of the state of health.
Is it possible to take a general blood test for a child for a fee, where and how much will it cost?
There are situations when you need to take a general blood test, but at the same time there is no time to wait for a coupon from the clinic. Of course, in this case, you can donate blood in the laboratory for a fee. Many paid clinics and laboratories have opened in every city today.
As a rule, there are no queues and there is no need to sign up. You just need to come up to the clinic's working hours in the morning and get tested. But no one will give advice after receiving the results, so it is advisable to contact a specialist for decoding. The average price for a complete blood count in the Russian Federation is 500 rubles.
Conclusion
A complete blood count is a seemingly simple procedure, but at the same time it carries a lot of information for the doctor. To obtain accurate data, it is important to follow all the rules for preparing for this manipulation. Parents who have received blood test results, the decoding of which is not clear to them, are advised to seek qualified medical help.
