Determining a revised white blood cell count involves adjusting the initially measured value to account for the presence of nucleated red blood cells (NRBCs) in a peripheral blood sample. When NRBCs are present in significant numbers, they can be mistakenly counted as white blood cells by automated hematology analyzers, leading to an artificially elevated WBC count. The corrected value provides a more accurate representation of the true leukocyte concentration. For example, if an automated count yields a WBC of 10,000/L with 10 NRBCs per 100 white blood cells observed on a blood smear, a formula is applied to obtain the adjusted WBC count.
Accurate leukocyte quantification is crucial for proper diagnosis and management of various hematological and systemic conditions. An inflated WBC count due to the presence of NRBCs can lead to misdiagnosis and inappropriate treatment. This correction is particularly important in neonates, patients with severe anemia, and individuals with certain bone marrow disorders, where NRBCs are more commonly encountered. Historically, manual microscopic examination was the sole method for identifying and correcting for NRBCs. The advent of automated hematology analyzers has streamlined this process, but manual review remains essential for validation, especially in cases with high NRBC counts.
