NRBC - Nucleated Red Blood Cells

Nucleated Red Blood Cells : How to Calculate the Corrected WBC Count -

1. In the name of God the Compassionate and the Merciful

2. NRBC : Nucleated Red Blood Cells Produced by Behnam Taheri Clinical Laboratory Technologist Medilam University Iran

3. NRBC A nucleated red blood cell (NRBC ) is a mammalian RBC that contains a cell nucleus . NRBCs occur in normal development as progenitor cells in the erythropoietic lineage and in pathological states . Normally, nucleated RBCs are found only in the circulation of fetuses and newborn infants .

4. After infancy, RBCs normally only contain a nucleus during the very early stages of the cell's life, and the nucleus is ejected as a normal part of cellular differentiation before the cell is released into the bloodstream .

5. Thus, if NRBCs are seen on an adult's peripheral blood smear, it suggests that there is a very high demand for the bone marrow to produce RBCs, and immature RBCs are being released into circulation . Possible pathologic causes include anemia, myelofibrosis , thalassemia , military tuberculosis , cancers involving bone marrow ( myelomas, leukemias , lymphomas), and in chronic hypoxemia.

6. The most common type of nRBC that is seen in blood is the fully hemoglobinized or orthochromic normoblast ( a cell with redcytoplasm and a small pyknotic nucleus ).

7. How to Calculate the Corrected WBC Count When you conduct a WBC count, you actually receive a total that includes both WBCs and nucleated red blood cells. Nucleated red blood cells are the precursors to normal red blood cells and look very similar to WBCs. To obtain the real total of WBCs, you need to correct for the presence of nucleated red blood cells; and there is a simple formula you can use to accurately calculate the corrected WBC count.

8. Multiply the uncorrected WBC count by 100. For example: 15,000 × 100 = 1,500,000 Add 100 to the total number of NRBCs you observed per 100 WBCs. In this example: 6 + 100 = 106 Divide the second total from the first total. 1,500,000 ÷ 106 = 14,150.94 Therefore, in this example, the corrected WBC count can be rounded up to 14,151. The corrected WBC count equals the uncorrected WBC count multiplied by 100, and this total divided by the number of nucleated red blood cells added to 100.

9. Thanks fo r your attention