Pediatric Normal CBC ranges

W.El Gendy MD
Prof. Clinical Pathology
Alexandria university
• The interpretation of any laboratory test
result requires assessment as to whether
or not the result is normal.
• ‘Normal’ means that the results are those
expected in that individual when in a state
of optimal health (assuming that the
person does not have any inherited
disorder affecting the blood).
• There are some effects of the method of
obtaining a blood specimen on
haematological variables:
• Site of obtaining blood specimen: During
the first week of life, the Hb, PCV/Hct and
RBC are approximately 15% higher in
heel-prick than in venous specimens; the
difference may be greater in babies with
sepsis with poor peripheral circulation.
• In neonates, heel-prick specimens have WBC,
neutrophil and lymphocyte counts about 20%
higher than arterial or venous samples; counts
are most likely to approximate to those of
venous blood if there is a free flow of blood and
if early drops, excluding the first, are used for the
count; in adults, the WBC and the neutrophil
count are significantly higher in finger-prick
samples than in venous samples with a
progressive fall occurring with successive drops.
 HEMOGLOBIN
• Females
• 1–7 days: 13.5–22.0 g/dL
• 8–14 days: 12.5–21.0 g/dL
• 15 days–1 month: 10.0–20.0
g/dL
• 2–5 months: 10.0–14.0 g/dL
• 6 months–2 years: 10.5–13.5
g/dL
• 2 years-3 ys: 11.0–14.0 g/dL
• 3–5 years: 11.8–14.7 g/dL
• 6–11 years: 12.0–14.5 g/dL
• 12–15 years: 12.2–14.8 g/dL
• Adults: 12.0–15.5 g/dL
• Males
• 1–7 days: 13.5–22.0 g/dL
• 8–14 days: 12.5–21.0 g/dL
• 15 days–1 month: 10.0–20.0
g/dL
• 2–5 months: 10.0–14.0 g/dL
• 6 months–2 years: 10.5–13.5
g/dL
• 2 years-3 ys: 11.0–14.0 g/dL
• 3–5 years: 11.0–14.5 g/dL
• 6–11 years: 12.0–14.0 g/dL
• 12–15 years: 12.8–16.0 g/dL
• Adults: 13.5–17.5 g/dL
 Hemoglobin Critical Values
• <12 years:<7.5 g/dL 
• >12 years:<6.0 g/dL 
 RBCs
• Females
• 1–7 days: 3.9–6.0 x 1012/L
• 8–14 days: 3.6–6.0 x 1012/L
• 15 days–1 month: 3.0–5.5 x
1012/L
• 2–5 months: 3.1–4.5 x 1012/L
• 6–11 months: 3.7–6.0 x 1012/L
• 1–2 years: 3.7–6.0 x 1012/L
• 2 years: 4.1–5.1 x 1012/L
• 3–5 years: 4.1–5.2 x 1012/L
• 6–11 years: 4.1–5.3 x 1012/L
• 12–15 years: 4.1–5.2 x 1012/L
• Adults: 3.90–5.03 x 1012/L
• Males
• 1–7 days: 3.9–6.0 x 1012/L
• 8–14 days: 3.6–6.0 x 1012/L
• 15 days–1 month: 3.0–5.5 x
1012/L
• 2–5 months: 3.1–4.5 x 1012/L
• 6–11 months: 3.7–6.0 x 1012/L
• 1–2 years: 3.7–6.0 x 1012/L
• 2 years: 4.1–5.1 x 1012/L
• 3–5 years: 4.1–5.3 x 1012/L
• 6–11 years: 4.2–5.1 x 1012/L
• 12–15 years: 4.4–5.5 x 1012/L
• Adults: 4.32–5.72 x 1012/L
 MCV
• Males
• 1–7 days: 88–120 fL
• 8–14 days: 86–120 fL
• 15 days–1 month: 85–
110 fL
• 2–5 months: 77–110 fL
• 6 months–5 years: 74–89
fL
• 6–11 years: 76.5–90.6 fL
• 12–15 years: 81.4–91.9
fL
• Adults: 81.2–95.1 fL
• Females
• 1–7 days: 88–120 fL
• 8–14 days: 86–120 fL
• 15 days–1 month: 85–
110 fL
• 2–5 months: 77–110 fL
• 6 months–5 years: 74–89
fL
• 6–11 years: 78.5–90.4 fL
• 12–15 years: 79.9–92.3
fL
• Adults: 81.6–98.3 fL
 Hematocrit
• Males
• 1–7 days: 42–60%
• 8–14 days: 39–60%
• 15 days–1 month: 31–55%
• 2–5 months: 28–42%
• 6 months–2 years: 33–40%
• 2 years: 33–42%
• 3–5 years: 33–43%
• 6–11 years: 35.8–42.4%
• 12–15 years: 37.3–47.3%
• Adults: 38.8–50.0%
• Females
• 1–7 days: 42–60%
• 8–14 days: 39–60%
• 15 days–1 month: 31–55%
• 2–5 months: 28–42%
• 6 months–2 years: 33–40%
• 2 years: 33–42%
• 3–5 years: 35–44%
• 6–11 years: 35.7–43.0%
• 12–15 years: 36.3–43.4%
• Adults: 34.9–44.5%
• Reticulocyte Count
• Infants 2 - 5% of RBCs
• Children 0.5 - 4% of RBCs
• 12-18 years (male) 0.5-1% of RBCs
• 12-18 years (female) 0.5-2.5% of RBCs
 WBC
• Males
• 1–7 days: 9.4–34.0 x 109/L
• 8–14 days: 5.0–21.0 x 109/L
• 15 days–1 month: 5.0–20.0 x
109/L
• 2–5 months: 5.0–15.0 x 109/L
• 6 months–2 years: 6.0–11.0 x
109/L
• 2 years: 5.0–12.0 x 109/L
• 3–5 years: 4.0–12.0 x 109/L
• 6–11 years: 3.4–9.5 x 109/L
• 12–15 years: 3.6–9.1 x 109/L
• Adults: 3.5–10.5 x 109/L
• Females
• 1–7 days: 9.4–34.0 x 109/L
• 8–14 days: 5.0–21.0 x 109/L
• 15 days–1 month: 5.0–20.0 x
109/L
• 2–5 months: 5.0–15.0 x 109/L
• 6 months–2 years: 6.0–11.0 x
109/L
• 2 years: 5.0–12.0 x 109/L
• 3–5 years: 4.0–12.0 x 109/L
• 6–11 years: 3.4–10.8 x 109/L
• 12–15 years: 4.1–8.9 x 109/L
• Adults: 3.5–10.5 x 109/L
 WBC Critical Values
•  < 1 week: <4.0 & >30.0X 103/cmm 
• 1 week-12 years:<4.0 & >20X103/cmm
•  >12 years:<1.0 and >30X103/cmm 
 Platelet Count
• 0–5 months: 150–350 x 109/L
• ≥6 months: 150–450 x 109/L
• Adults: 150-450 x 10 9/L
 Critical values
• Platelet count: < 25X109 /L
• The numbers of leukocytes changes with age
and during pregnancy.
• On the day of birth, a newborn has a high white
blood cell count, ranging from 9,000 to
30,000/cmm leukocytes. This number falls to
adult levels within two weeks.
• The percentage of neutrophils is high for the first
few weeks after birth, but then lymphocyte
predominance is seen.
• Until about 8 years of age, lymphocytes are
more predominant than neutrophils.
 Differential WBC count
• LYMPHOCYTES
•  0-4 years: 20-70%   
•  4-16 years: 21-55%   
•  16 years: 8-44%
• Lymphopenia: less than 1000/cmm
• Lymphocytosis: according to age
• SEGMENTED NEUTROPHILS
•  0-4 years: 16-60%   
•  4-16 years: 33-70%  
•   16 years: 44-80%   
•  BANDS
•   0-4 years: 0-4%  
•   4-16 years: 0-4%   
•  16 years: 0-6%
 Differential WBC Count
• Two measurements of white blood cells are
commonly done in a CBC:
• the total number of white blood cells in a
microliter (1x10-9 liters) of blood, reported as an
absolute number of "X" thousands of white blood
cells, and
• the percentage of each of the five types of white
blood cells. This test is known as a differential
or "diff" and is reported in percentages.
• neutropenia in children when
neutrophils are less than 1500/cmm
• > 20% Bands or other young cells
indicate a shift to the left, i.e. infection
is suspected.
• Neutrophilia above 6000/cmm  
 Critical values
• A WBC of less than 500/cmm places the
patient at risk for a fatal infection.
• A WBC over 30,000/cmm indicates
massive infection or a serious disease
such as leukemia.
• MONOCYTES
• 0-4 years: 0-7%    
• 4-16 years: 3-13%   
•  16 years: 2-8 %   
• EOSINOPHILS
•  0-4 years: 0-8%   
•  4-16 years: 2-12%  
•   16 years: 0-6%
• BASOPHILS
•  0-4 years: 0-3%    
• 4-16 years: 0-3%   
•  16 years: 0-3%
• Eosinophilia, when absolute
eosinophils are > 1000/cmm