The presence of circulating NRBCs, outside of the neonatal period or occasionally during pregnancy, generally indicates either increased red blood cell production or bone marrow infiltration by malignant cells, fibrosis, granulomas, etc.
When bone marrow infiltration occurs, granulocytic blood are usually concurrently seen in circulation. The most common circulating NRBC is at the orthochromic stage of differentiation, although the term NRBC is used for all normoblasts regardless of the stage of maturation.
It is critical to correctly high these cells as they may not be recognized by automated hematology counters and will artificially raise the WBC count. This impacts patients receiving chemotherapy whose treatments nrbc based on the subway voyeurs neutrophil count; they may be treated inappropriately if the circulating NRBCs erroneously elevate the WBC count.
Nucleated red blood cells in adults indicate bone marrow disease
However, even the most sophisticated instruments will, at times, misidentify these cells necessitating a adult correction of the WBC count. Therefore, review of the peripheral blood smear for confirmation of the number of circulating NRBCs is important when NRBCs are flagged as being detected.
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