Anaemia

CBE with reticulocyte counts, MBA 20, serum iron studies, serum B12 and folate, haemoglobin electrophoresis if haemoglobinopathy suspected. 

High Hb

carboxyhaemoglobin, serum erythropoietin, early haematological opinion if PCV > 0.47, JAK2 kinase.

Lymphadenopathy

viral studies, please call us if to discuss whether CT scans, fine needle aspirations or core biopsy are necessary.

High neutrophil count

look out for infection and splenomegaly, early haematological opinion if neutrophil count >50 or if abnormal immature cells present.

High lymphocyte count

PB immunophenotype

More than 5% blast count

early haematological opinion recommended.

High monocytes count

TB, infectious mononucleosis, Chronic myelomonocytic leukaemia

High eosinophil count

parasites, look for drug allergy.

High platelet count

look for infection/bleeding, early haematological opinion if platelet count >800.

Low neutrophil count

autoimmune markers, B12/folate, early haematologist opinion if neutrophil count <1.

Low lymphocyte count

protein electrophoresis and immunoglobulin levels. 

Low platelet count

autoimmune markers, HIV, B12/folate.  Early haematological opinion if platelet < 50.

High globulin

PB immunophenotype, serum immunoglobulin/paraprotein, serum free light chain, early haematological opinion if paraprotein >10, anaemic, hypercalcaemia and impaired renal function.

High globulin with bone pain

above with imaging of painful area.