Why one number is not a diagnosis
Blood counts vary with age, sex, pregnancy, altitude, hydration, recent illness, medicines and laboratory method. A mild abnormality may be transient. The meaning depends on the full blood count, the blood film, symptoms, examination and the trend over time.
The most useful first step is often a repeat test rather than an immediate expensive work-up. A blood film review by an experienced haematologist adds information that the automated counter cannot provide, including cell shape, clumping, blasts and abnormal cells.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
Common abnormalities
Low haemoglobin suggests anaemia, which may be due to iron deficiency, thalassemia, chronic disease, bleeding, haemolysis or a marrow problem. A high white cell count can reflect infection, inflammation, steroid use or a blood cancer, while a low count can follow a viral illness, medicine, autoimmune disease or marrow failure.
Low platelets may be immune-mediated, drug-related, caused by infection or due to marrow disease. High platelets are often reactive. Pancytopenia, where all three cell lines are low, needs prompt assessment. Abnormal cells on the film, unexplained blasts or a rapidly changing count need urgent haematology review.
| Finding | Possible meaning | Next step |
|---|---|---|
| Low haemoglobin with low MCV | Iron deficiency or thalassemia trait | Iron studies, ferritin, blood film |
| Low platelets with bruising | ITP, drug effect, infection or marrow cause | Repeat count, film, review medicines |
| High white cells with immature cells | Infection or leukaemia | Urgent film and haematology assessment |
| Pancytopenia | Marrow failure, MDS, aplastic anaemia or infiltration | Urgent marrow evaluation |
What to bring and what happens next
Bring the original report, any previous counts, a list of medicines including supplements and herbal products, recent illness and vaccination history, menstrual and bleeding history, and family history of blood disorders. If you have had a transfusion, tell the doctor when.
Further tests may include a blood film, reticulocyte count, iron studies, vitamin B12 and folate, liver and kidney tests, infection screening, flow cytometry or a bone marrow biopsy. Not every abnormality needs a biopsy. The plan should explain which question each test answers and when to repeat the count.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, blood film, marrow, flow cytometry and molecular reports.