WBC Correction for the Presence of Nucleated Red Blood Cells

Any nucleated red blood cells present in a whole blood sample are not lysed by the diluting fluid when doing a white blood cell count, either by manual or by automated methods. The nucleated red cells are counted as white blood cells on the hemacytometer and by the instrument because they are indistinguishable from small lymphocytes. If five or more nucleated red blood cells (nRBC) are seen per 100 WBCs when performing a differential, the total white count MUST be corrected for the presence of these nucleated red cells. The formula is as follows: uncorrected WBC count X 100 number of nRBCs per 100 WBCs + 100 The count should be reported as a corrected WBC count.. Example: 8 nucleated red blood cells are seen while performing a differential on a smear of peripheral blood from a patient. The leukocyte count reported by the Coulter Counter was 17,400 mm3. What is the actual leukocyte count? 17,400 X 100 8 + 100 = 1740000 108 = 16,111 mm3 corrected = corrected WBC count (mm3)

Reference: Rodak, Diagnostic Hematology, 1995, p. 132.

152372507.doc Monday, June 17, 2013