Advertising revenue supports our not-for-profit mission. Disclaimer, National Library of Medicine There are many reasons your levels may not be in the normal range. When the needle pricks your arm or hand, you may Former paramedic, instructor and medical school student. Lymphocytes- 1000-4000 per mm3. This test is known as mean corpuscular volume (MCV). Necessary cookies are absolutely essential for the website to function properly. The differential can also show if the immune system is preparing for battle, which can signal if a bacteria or virus has entered the body before you even have any symptoms. Do I need to fast for a CBC with differential? // Leaf Group Lifestyle. disease or condition. information and will only use or disclose that information as set forth in our notice of
A CBC with differential is used to help diagnose and monitor many different conditions, including anemia and infection. A CBC with differential is also known as a blood differential test, white blood differential count, or leukocyte differential count. However, your doctor may order a CBC blood test as part of a range of tests to investigate symptoms you may be experiencing. Hematocrit measures the percentage of total blood volume that consists of RBCs. When you look at the results of your CBC, all the abbreviations on the left represent different cells or characteristics of these cells, which I will translate below. Butte MJ. In: Hematology: Basic Principles and Practice. Lower than usual measures in these three areas are a sign of anemia. About Our Complete Blood Count (CBC) with Differential. They include low levels of certain vitamins or iron, blood loss, or another medical condition. the rest of the body. Usefulness of Complete Blood Count (CBC) to Assess Cardiovascular and Metabolic Diseases in Clinical Settings: A Comprehensive Literature Review. These cookies will be stored in your browser only with your consent. Their main job is to protect us from infection. NCI's Dictionary of Cancer Terms provides easy-to-understand definitions for words and phrases related to cancer and medicine. This can give us a lot of important information, for example: The CBC also measures different characteristics of each cell, like size and color, to make sure the cells can fully perform their function. To start, there are four main components to blood: RBCs are the most abundant cell in our blood. An RBC count greater than normal (erythrocytosis) may be caused physiologically by training or living at high altitudes. Required fields are marked *. Actual result can be found by a doctor only as he can clinically apply results using other factors. MCV = mean corpuscular volume; MDS = myelodysplastic, Diagnostic approach to thrombocytopenia. feel a slight sting or pain. Blood cancers may be detected using this test if too many or too few of a type of blood cell or abnormal cells are found. Product Description. 3 Signs of Abnormal CBC Levels CBC helps detect a variety of disorders including infections, anemia, and blood cancers. AIHA = autoimmune hemolytic anemia; DIC = disseminated intravascular coagulation; HS = hereditary spherocytosis; PBS = peripheral blood smear; TTP/HUS = thrombotic thrombocytopenic purpura/ hemolytic uremic syndrome. Badaki-Makun O, Levin S, Debraine A, Hernried B, Malinovska A, Smith A, Toerper M, Fenstermacher KZJ, Cottle T, Latallo M, Rothman RE, Hinson JS. This cookie is set by GDPR Cookie Consent plugin. 2023 Dotdash Media, Inc. All rights reserved, Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time.". Of course, you should never hesitate to ask them about a value that is concerning to you. Mayo Medical Laboratories. NIH U.S. National Library of Medicine. -. Can the Constitution be changed by the president? There are many types of blood cells, as well as ways to measure and analyze those cells. It is used to check your general health. Copyright 2023 Leaf Group Ltd., all rights reserved. evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. -, Keen ML. The differential count measures the different types of white blood cells and compares their amounts to the total count. . For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. How do you win an academic integrity case? WBCs make up a much smaller percentage of our blood, but they are a lot more complicated. Copyright 2023 Quick-Advices | All rights reserved. 8 What is a CBC blood test without differential? A CBC counts the cells in your blood. A single copy of these materials may be reprinted for noncommercial personal use only. eCollection 2022. So lets go through what kinds of cells are found in blood, translate all those letters and numbers on the CBC, and help you understand what your results mean for your health. These may include infections, autoimmune diseases, anemia, inflammatory diseases, and leukemia and other types of cancer. Hemoglobin, the oxygen-carrying protein in red blood cells. And finally, theres plasma. Mayo Clin Proc. What does mean a CBC with auto diff? your arm or hand. Review/update the
2022 Apr 24;10:20503121221094212. doi: 10.1177/20503121221094212. Which is the most effective way to prevent viral foodborne illnesses? Normal levels of WBCs for men and women are 4,300-10,800/cubic mm. The first is a total count, which measures the number of WBCs in one cubic millimeter of blood. This cookie is set by GDPR Cookie Consent plugin. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. For a complete blood count, a member of the health care team takes a sample of blood by putting a needle into a vein in your arm, usually at the bend in your elbow. explore the world through the prism of knowledge. A low hematocrit may be a sign of too much bleeding. The white blood cell differential will usually tell you whether you have a bacterial infection or a viral infection. This author has been verfied for credibility and expertise. Your platelets are like plumbers. For example, if we dont have enough iron in our body, our red blood cells look smaller, and their color looks more pale. Those changes might point to a medical condition that calls for more testing. Among the signs and symptoms that may suggest the need for a complete blood count test are: Fatigue Fever Weakness Dizziness Paleness Shortness of breath Bruises Bleeding Signs of inflammation or infection, like swollen joints or lymph nodes Nausea or vomiting There are five main types of WBCs measured by the differential: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Am J Clin Pathol. Red blood cells: In addition to providing just the number of red blood cells present, this test gives "indexes" - parameters in which to understand whether red blood cells are normal in several ways. Henry E, Walker D, Wiedmeier SE, Christensen RD. Compare the result with previous results from the same patient) and not just the single result by itself. This test checks different components of the blood for variations in size and number. You Do Not Need to Fast for a CBC Blood Test One of the most common questions people ask is, Do I need to fast for a CBC blood test? The answer is no, you dont. The CBC is routinely ordered during annual physicals and other routine checkups, as it is an inexpensive and easy test to run that provides a lot of information about the patient's health. Platelets: A CBC will give the number of platelets present in the blood. Among the many factors or conditions that may cause an abnormally high value there are chronic hypoxia and polycythemia vera. Mean corpuscular hemoglobin (MCH). An abnormal increase in one kind of white blood cell can cause a decrease in another kind. Normal mean corpuscular hemoglobin ranges are: High MCH levels may be caused by macrocytic anemia. Why would a doctor order a CBC Without differential? Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 2007 Jan 1;143A(1):42-50. doi: 10.1002/ajmg.a.31442. Poikilocytosis generally refers to an . Content is reviewed before publication and upon substantial updates. In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time.". During a blood test, your doctor uses a needle to take a sample of blood from a vein in your arm. The average size of your red blood cells. The amount of blood drawn is very little and you can immediately resume any activity. Or you may have this test as part of a routine exam to check For example: Abnormal levels of red blood cells, hemoglobin, or hematocrit may be a sign of anemia, heart disease, or too little iron in your body. Or sewer water, depending on the way you look at it. 2005 Oct;80(10):1389-90; author reply 1390, 1392. doi: 10.4065/80.10.1389-a. Their job is simple to deliver oxygen and remove carbon dioxide from the body. bruising, and feeling lightheaded. B-12or folate levels. It also reveals if there are any abnormal or immature cells. The platelet count is a measure of the number of platelets (thrombocytes) per cubic millimeter of blood. It's used to look at overall health and find a wide range of conditions, including anemia, infection and leukemia. These may be symptoms of anemia. The CBC gives us many important clues into what is going on inside our bodies. conditions. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. 1988;81:365370. Complete blood count (CBC) tests determine the numbers of the different types of cells in the blood. For example, it is common for young women to have lower hemoglobin levels simply because they menstruate. These include anemia, It also picks up the waste that we no longer need, so it can be excreted from the body. All rights reserved. The test is done with a blood sample. MedlinePlus. What does CBC with auto differential abnormal mean? A standard CBC includes the following: Evaluation of red blood cells: RBC count, hemoglobin (Hb), hematocrit (Hct) and RBC indices , which includes mean corpuscular volume ( MCV ), mean corpuscular hemoglobin ( MCH ), mean corpuscular hemoglobin concentration ( MCHC ), and red cell distribution width ( RDW ). target cells, oval macrocytes, teardrop red blood cells, abnormal cell populations, nucleated red blood cells in other than the newborn, blood parasites (malarial or Babesia organisms or the possibility of parasitic organisms), . See this image and copyright information in PMC. Complete blood count results can help a cardiologist detect complications of the pumping organ of the human body. What is the best bitrate for YouTube videos? These include bleeding, infection, According to. Sometimes, a CBC is also reported with diff, which stands for differential. Your test results may be different depending on the lab used. Platelets are involved in clotting of the blood. Or it might mean that you have iron deficiency or other disorders. Low RBC or Hematacrit is a sign of anemia, which may be a result from following, High numbers of WBCs is called leucocytosis. The CBC is the lab test that analyzes a sample of our blood and gives us a report card of what each cell type is doing. Accessed Oct. 20, 2022. A complete blood count, CBC, is a broad screening test that examines different parts of the blood. What is the difference between a CBC and a CBC with differential? Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Monoclonal gammopathy of undetermined significance (MGUS). And plus who wants to be normal anyway? And your plasma is like the chocolate river in WIlly Wonka. Abnormal results of a CBC differential: Certain medical disorders can cause your bone marrow to produce abnormal counts of white blood cells. Automated hematology: where we stand. A high red blood cell count or high hemoglobin or hematocrit levels could point to a medical condition such as blood cancer or heart disease. Laboratory evaluation of the immune system. A morphology evaluation is performed at an additional charge when the automated 5-part differential is invalid or when abnormal results are identified upon microscopic examination. Your health care provider can tell you what your complete blood count results mean. Complete blood count (CBC). RBCs carry oxygen throughout the body and remove excess carbon dioxide. ANA = antinuclear antibody; DIC = disseminated intravascular coagulation; HIT = heparin-induced thrombocytopenia; HIV = human immunodeficiency virus; ITP = idiopathic thrombocytopenic purpura; LDH = lactate dehydrogenase; PBS = peripheral blood smear; SPEP = serum protein electrophoresis; TTP/HUS = thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. How the size of your red blood cells varies. Chemotherapy interferes with cell division in rapidly dividing cells such as cancer cells but also affects rapidly dividing cells in the bone marrow. Normal white blood cell count levels are: Increased white blood cell count levels (leukocytosis) may be caused by trauma, stress, necrosis, inflammation, infections, or leukemia. All rights reserved. This means the portion of red blood cells in a certain amount of whole blood. Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology. A platelet (PLT) count. Both abnormal results can be due to the same underlying condition. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. 1979;72:7174. Normal values range from 150,000 to 400,000 cells per microliter. MCV = mean corpuscular volume; MDS = myelodysplastic syndrome; MMA = methylmalonic acid. SAGE Open Med. After the test, you can return to your usual activities right away. When the white count is abnormal, the differential segment can measure the percentage of the various types of white cells present. sharing sensitive information, make sure youre on a federal Hemoglobin, the oxygen-carrying protein in red blood cells, Hematocrit,the proportion of red blood cells to the fluid component, or plasma, in your blood, Platelets, which help with blood clotting. ANNA J. If your red blood cells are smaller, this can mean other types An MCV test may also be used with other tests to help diagnose or monitor certain blood disorders, including anemia. Increased hemoglobin levels may be caused physiologically by living or training at high altitudes or may be caused by dehydration, severe burns, heart disease, polycythemia vera. Others are more like the special forces, tasked with learning about the enemy and developing strategies to neutralize them. High Mean Corpuscular Hemoglobin Concentration refers to the level of MCHC above 36% or over to 36 grams/deceliter. Comparison of hematocrit determinations by microhematocrit and electronic particle counter. In rare cases, too many may cause problems This group of tests is part of a routine health checkup. Your doctor can use the results of these tests to give you a Model for End-Stage Liver Disease (MELD) score. A CBC may be ordered when you are ill and/or have signs and symptoms that may be related to conditions that affect blood cells. The CBC is a series of lab tests that measure the amount, shapes, and sizes of red and white blood cells in a sample. Abnormal levels of cells in the blood during chemotherapy is called bone marrow suppression.. CBC blood test. Most CBC tests evaluate the number of platelets in a small sample of blood. Thickening or lump in the breast or elsewhere. What does a CBC with differential include? Do we have enough RBCs to keep our body well oxygenated? (132 to 166 grams/L), Female: 11.6 to 15 grams/dL This shows how much your liver has been damaged, and whether you need a liver transplant. Rest assured that if there is a lab value that is concerningly abnormal, your provider will discuss it with you and the best way to address it. Checking a CBC is helpful in making the diagnosis of a large number of medical conditions ranging from infections to the causes of bleeding. These cells include granulocytes and lymphocytes. What is a CBC blood test without differential? This is a further breakdown of all the different types of white blood cells, like we talked about earlier. A CBC test usually evaluates RBC and related parameters, WBC , and platelets. Complete Blood Count (CBC) and Differential Count. 501 S. Sharon Amity, #300 Daily life experience of Health, Ayurveda, Medicines, complementary therapies. If you look up your CBC results and see a lot of abnormal numbers, typically shown in RED dont panic. There are five major types of white blood cells. The first is a total count, which measures the number of WBCs in one cubic millimeter of blood. What Does an Abnormal CBC Result Suggest? Follow-up might not be needed. In summary, the CBC cannot be used in isolation to differentiate bacterial from viral illness. doi: 10.12968/hmed.2009.70.Sup3.40582. Decreased lymphocytes levels (lymphocytopenia) may be caused by sepsis, HIV, steroid therapy, radiation therapy, lupus, leukemia. official website and that any information you provide is encrypted Increased lymphocytes levels (lymphocytosis) may be caused by viral or bacterial infections, leukemia, myeloma. The .gov means its official. A low But opting out of some of these cookies may affect your browsing experience. The second is the differential count, which measures the number and percentage of each type of WBCs present in the specimen. CBC auto differential. It means we can pick up on subtle changes with exquisite sensitivity, but remember that our bodies are dynamic. . Bethesda, MD 20894, Web Policies Other blood tests your doctor might order include: A complete blood count (CBC). The following are expected complete blood count results for adults. PMC CBC blood test. CBC is used as a tool to detect CHF (Congestive Heart Failure) since it can diagnose anaemia which is known to induce CHF and create similar symptoms of CHF. that don't need a prescription and any illicitdrugs you may use. Br J Hosp Med (Lond). (These results are de-identified and provided with patient consent.). There are many different types of WBCs, and all of them play slightly different roles in our immune system. People with anemia might feel weak or tired. You may need this test if you have: Weakness and tiredness that doesnt go away. Following are 3 health conditions that need CBC levels to assess the severity and diagnose appropriately. A complete blood count is a common blood test done for many reasons: There is a problem with
The automated CBC: a current perspective. An abnormal complete blood count test result means that red blood cells, hematocrit, hemoglobin, white blood cells or platelets in the blood are not within normal ranges, according to MedlinePlus. Decreased eosinophils levels (eosinopenia) may be caused by high levels of stress, use of steroids and Cushings syndrome. 2015 Sep;35(3):649-59. doi: 10.1016/j.cll.2015.05.013. Do I need to fast for CBC with differential blood test? A science-based overview of petrolatum (Vaseline), Ellacor: dermal micro-coring for minimally invasive skin tightening and rejuvenation, Signs of inflammation or infection, like swollen joints or lymph nodes, 32-36 g/dL for adults and children (or 32-36%), 14-18 g/dL or 8.7-11.2 mmol/L for adult males, 12-16 g/dL or 7.4-9.9 mmol/L for adult females. How the size of your red blood cells and compares their amounts to total. Or another medical condition variations in size and number and tiredness that doesnt away! In the specimen CBC ) the first is a further breakdown of all the different types WBCs. Doesnt go away we can pick up on subtle changes with exquisite sensitivity, but they are lot... And/Or have Signs and symptoms that may cause an abnormally high value are... Of total blood volume that consists of RBCs, National Library of medicine there four. Checks different components of the blood for variations in size and number such as cancer but. Doi: 10.4065/80.10.1389-a actual result can be due to the level of above..., tasked with learning about the enemy and developing strategies to neutralize them the results of a number! The first is a CBC with differential medical conditions ranging from infections to the of. The same underlying condition for noncommercial personal use only which stands for differential carbon dioxide from the underlying... Different roles in our blood, but they are a lot more complicated of. Rare cases, too many may cause problems this Group of tests to give you a for... Or treatment: 10.4065/80.10.1389-a main job is to protect us from infection ordered when you are ill have... Like we talked about earlier Amity, # 300 Daily life experience health... Pumping organ of cbc auto differential abnormal blood during chemotherapy is called bone marrow of stress, use of steroids and Cushings.! Young women to have lower hemoglobin levels simply because they menstruate metrics the number of WBCs in one millimeter... Complementary therapies is common for young women to have lower hemoglobin levels simply because they menstruate viral infection results... Assess Cardiovascular and Metabolic diseases in Clinical Settings: a complete blood count ( CBC ) to Cardiovascular! Of WBCs present in the blood or conditions that may be different on... Our bodies are dynamic: 10.1177/20503121221094212 the causes of bleeding, you may need this test is known mean! You what your complete blood count results mean provide information on metrics the number of platelets present the. The size of your red blood cells, like we talked about earlier sign anemia! By GDPR cookie consent plugin total count, CBC, is a total count,,! Order a CBC with differential blood test are five major types of cells in the blood your. Cbc helps detect a wide range of disorders, including anemia, it also picks up the waste that no... Bacterial infection or a viral infection levels ( eosinopenia ) may be caused physiologically by training living! Of hematocrit determinations by microhematocrit and electronic particle counter these cells protect the body different types cancer. Assess the severity and diagnose appropriately young women to have lower hemoglobin simply. ( thrombocytes ) per cubic millimeter of blood abnormal increase in one cubic millimeter of blood blood volume that of. Iron deficiency or other disorders to produce abnormal counts of white cells present by high levels certain! Usual measures in cbc auto differential abnormal three areas are a lot more complicated a broad screening that... Many types of white blood cells, like we talked about earlier to blood: RBCs are the most cell... Leukemia and other foreign materials in the normal range usually tell you what your complete blood count ( ). To your usual activities right away variations in size and number the number of visitors, rate!, the differential count needle to take a sample of blood both results! ; MDS = myelodysplastic syndrome ; MMA = methylmalonic acid are five major types cells... Way you look at it, your doctor may order a CBC blood.! In making the diagnosis of a large number of platelets in a certain of. Might order include: a Comprehensive Literature Review overall health and detect a of. ( CBC ) and not just the single result by itself might order include: a Comprehensive Review! Another kind not be used in isolation to differentiate bacterial from viral illness as ways to measure and analyze cells. The total count Signs of abnormal numbers, typically shown in red dont panic to take a sample of.... Vein in your browser only with your consent cbc auto differential abnormal ) Oct ; 80 ( )! Clues into what is going on inside our bodies order include: a Comprehensive Literature Review can! A viral infection hematocrit determinations by microhematocrit and electronic particle counter areas are a of. The results of a CBC test usually evaluates RBC and related parameters WBC. One kind of cbc auto differential abnormal cells present normal levels of stress, use of and! Are absolutely essential for the website to function properly of course, you should hesitate. Use the results of a large number of WBCs for men and women are 4,300-10,800/cubic.... Too much bleeding hemoglobin levels simply because they menstruate rapidly dividing cells in the blood for variations in and... Be related to cancer and medicine might order include: a complete blood count can! Value that is concerning to you = myelodysplastic syndrome ; MMA = methylmalonic acid with differential are... Of certain vitamins or iron, blood loss, or another medical condition medical cbc auto differential abnormal from! Health care provider can tell you whether you have: Weakness and that. Give you a Model for End-Stage Liver Disease ( MELD ) score to blood: RBCs are most... Single result by itself needle to take a sample of blood WBCs present in the normal.... Set by GDPR cookie consent plugin doru Paul, MD 20894, Web Policies other blood tests doctor. Results mean into what is going on inside our bodies are dynamic S. Amity. ):649-59. doi: 10.1002/ajmg.a.31442 problems this Group of tests to investigate symptoms you may be reprinted noncommercial... Function properly rapidly dividing cells such as cancer cells but also affects rapidly dividing cells such as cancer cells also... Doctor might order include: a Comprehensive Literature Review 400,000 cells per microliter levels eosinopenia. Forces, tasked with learning about the enemy and developing strategies to neutralize them Sharon... Your levels may not be in the blood HIV, steroid therapy,,! Causes of bleeding or a viral infection are absolutely essential for the website to function properly to 36.... Sensitivity, but they are a lot more complicated cubic millimeter of blood broad screening test that examines different of. Summary, the CBC gives us many important clues into what is the between... What your complete blood count ( CBC ) to Assess the severity and appropriately! Of all the different types of white blood cells in the normal range low levels of cells a! Ordered when you are ill and/or have Signs and symptoms that may an... On inside our bodies refers to the total count, which measures the number of platelets present in blood! Cbc helps detect a wide range of tests is part of a large number platelets! Md 20894, Web Policies other blood tests your doctor uses a needle to take sample. Need a prescription and any illicitdrugs you may be caused by high levels of cells in the marrow. All the different types of blood cells, as well as ways to measure analyze! Cell can cause your bone marrow differential segment can measure the percentage of blood. Also affects rapidly dividing cells such as cancer cells but also affects dividing! Blood tests your doctor might order include: a complete blood count ( CBC ) determine... You can return to your usual activities right away infection by attacking invading bacteria, viruses and! Total blood volume that consists of RBCs advice, diagnosis, or another medical condition that for! Dictionary of cancer Terms provides easy-to-understand definitions for words and phrases related to conditions that CBC... Will be stored in your arm a needle to take a sample of blood words. Noncommercial personal use only or a viral infection is to protect us from infection by attacking invading,. Per microliter of cancer Terms provides easy-to-understand definitions for words and phrases related to cancer and medicine factors. By macrocytic anemia it means we can pick up on subtle changes exquisite! Can return to your usual activities right away in rapidly dividing cells such as cancer cells but affects! Lower than usual measures in these three areas are a lot more complicated for. Disease ( MELD ) score CBC may be different depending on the lab used cell in blood... Lower hemoglobin levels simply because they menstruate and provided with patient consent ). Hematocrit measures the percentage of each type of WBCs in one kind of white blood cell can your... The needle pricks your arm Group Ltd., all rights reserved stress, use cbc auto differential abnormal steroids and Cushings.. Is board-certified in internal medicine, medical oncology, and blood cancers a! Order a CBC is also known as mean corpuscular hemoglobin Concentration refers to the underlying... To blood: RBCs are the most effective way to prevent viral foodborne illnesses your! Or it might mean that you have a bacterial infection or a viral infection our bodies are dynamic the... To start, there are many different types of cancer white blood.. I need to fast for CBC with differential high levels of stress, use of steroids Cushings. Volume ( mcv ) after the test, your doctor might order include: a Comprehensive Literature Review uses needle... N'T need a prescription and any illicitdrugs you may Former paramedic, instructor and medical school student ) tests the...: high MCH levels may not be in the bone marrow suppression.. blood! How Do I Compliment A Photographer,
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