Complete blood count CBC
The CBC is a snapshot of the cells and fluid in your bloodstream. Among other things, the CBC will tell the doctor how many red blood cells are present and how much hemoglobin is in them. It will give the doctor an evaluation of the size and shape of the red blood cells present also called the red cell indices.
These include the mean corpuscular volume (MCV), a measurement of the size of the red blood cells. A low MCV is often the first indication of thalassemia. If the MCV is low and iron-deficiency has been ruled out, the person may be a thalassemia trait carrier
(also called peripheral smear and manual differential). In this test, a trained laboratorian examines a thin layer of blood that is treated with a special stain, on a slide, under a microscope. The number and type of white blood cells, red blood cells, and platelets can be evaluated to see if they are normal and mature.
A variety of disorders affect normal blood cell production. With thalassemia, the
red blood cells are often microcytic
Red cells may also:
Vary in size (anisocytosis) and shape (poikilocytosis)
Be nucleated - normal, mature RBCs do not have a nucleus
Have uneven hemoglobin distribution (producing “target cells” that look like a bull’s-eye under the microscope)
The greater the percentage of abnormal looking red blood cells the greater the likelihood of an underlying disorder and of impaired oxygen-carrying capability.
These may include: iron, ferritin, unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC), and percent saturation of transferrin
These tests measure different aspects of the body’s iron storage and usage. They are ordered to help determine whether an iron deficiency is causing and/or exacerbating a patient’s anemia. One or more of them may also be ordered to help monitor the degree of iron overload in a patient with thalassemia