Paeds Cases · haematology-oncology-and-transfusion
Full blood count and blood-film interpretation in children — structured clinical encounter
Structured encounter testing the interpretation of a paediatric full blood count: a printout that must be read against age-specific ranges, the physiological anaemia of infancy, the mean-cell-volume sort of a microcytic anaemia with iron dosing and the thalassaemia distinction, a child with isolated thrombocytopenia, an EDTA artefact, and a film that demands urgent oncology review.
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Station 1 — the printout that needs an age
Asked for my first move on a haemoglobin of 100, I would say I cannot interpret a paediatric value without the age band, because the same number is normal at the physiological nadir of infancy and abnormal in an older child. I would state the age aloud and read every value against age-specific paediatric reference intervals, not adult ranges, and I would read the blood film alongside the count. [1] [4]
References7ShowHide
- [1]Adeli K; Higgins V; Seccombe D; et al The Canadian laboratory initiative on pediatric reference intervals: A CALIPER white paper. Crit Rev Clin Lab Sci, 2017.PMID 29017389
- [4]Celkan TT What does a hemogram say to us? Turk Pediatri Ars, 2020.PMID 32684755
- [5]Raleigh MF; Chaffin M; O'Connor K Anemia in Infants and Children: Evaluation and Treatment. Am Fam Physician, 2024.PMID 39700365
- [6]Wang M Iron Deficiency and Other Types of Anemia in Infants and Children. Am Fam Physician, 2016.PMID 26926814
- [8]Courville EL; et al Performance of Automated Hematology Analyzer Criteria in Detecting Peripheral Blood Smear Abnormalities: A Systematic Literature Review. Int J Lab Hematol, 2026.PMID 42115681
- [9]Neunert C; Terrell DR; Arnold DM; et al American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv, 2019.PMID 31794604
- [10]Rose-Inman H; Farmen J Acute leukemia. Emerg Med Clin North Am, 2014.PMID 25060251