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Nucleated red blood cell (NRBC)

Other names: Nucleated RBCS

Optimal Result: 0 - 0.001 / 100 WBCs.

The term 'NRBC' – 'nucleated red blood cells' – refers to precursor cells of the red blood cell lineage which still contain a nucleus; they are also known as erythroblasts or – obsolete – normoblasts. In healthy adults and older children, NRBC can only be found in blood-building bone marrow where they mature. Nucleated RBCs (NRBC, normoblasts) are a very immature form of RBCs seen when there is a severe demand for RBCs to be released by the bone marrow or marrow involvement by fibrosis or tumor;

What does it mean if your Nucleated red blood cell (NRBC) result is too high?

An elevated NRBC (Nucleated Red Blood Cell) count in a blood test can have various implications:

- An NRBC level higher than 0.02 x 10/L (20/μL) may be considered elevated, indicating the presence of nucleated red blood cells in the bloodstream.

- Nucleated RBCs (NRBCs) should not normally be present in the bloodstream of humans more than a few days old.

- An elevated NRBC count may predict poor outcomes in critical care settings and suggest serious underlying conditions.

- Nucleated RBCs can be normal in infants for a short time after birth.

- Elevated NRBCs can indicate underlying issues.

Potential causes of elevated NRBCs include:

- Severe anemia

Anemia is a problem of not having enough healthy red blood cells or hemoglobin to carry oxygen to the body's tissues. Hemoglobin is a protein found in red cells that carries oxygen from the lungs to all other organs in the body. Having anemia can cause tiredness, weakness and shortness of breath.

There are many forms of anemia. Each has its own cause. Anemia can be short term or long term. It can range from mild to severe. Anemia can be a warning sign of serious illness.

Treatments for anemia might involve taking supplements or having medical procedures. Eating a healthy diet might prevent some forms of anemia.

- Myelofibrosis

Myelofibrosis is a rare blood cancer. It causes scarring of the bone marrow which makes it more difficult to produce blood cells. It is one of a group of conditions called myeloproliferative neoplasms or myeloproliferative disorders.

- Thalassemia

Thalassemia is an inherited (i.e., passed from parents to children through genes) blood disorder caused when the body doesn't make enough of a protein called hemoglobin, an important part of red blood cells. Thalassemia is a treatable disorder that can be well-managed with blood transfusions and chelation therapy.

- Miliary tuberculosis

Miliary tuberculosis is a severe and potentially life-threatening form of tuberculosis (TB) caused by the airborne bacteria Mycobacterium tuberculosis. In this condition, a large number of TB bacteria enter the bloodstream and spread throughout the body, resulting in widespread dissemination of the infection.

- Cancers that involve the bone marrow / bone marrow damage or disorders.

Bone marrow cancer, also known as hematologic cancer or blood cancer, refers to various malignancies originating in the bone marrow, where blood cells are produced. Some common types include:

  1. Leukemia: Abnormal white blood cells proliferate uncontrollably in the bone marrow, impairing the body's ability to fight infections.

  2. Lymphoma: Abnormal cells in the lymphatic system may infiltrate the bone marrow, leading to lymphoma-related bone marrow cancer.

  3. Multiple Myeloma: This is a specific type of bone marrow cancer where plasma cells (a type of white blood cell) multiply excessively, potentially leading to bone damage and other complications.

Bone marrow cancer can present with symptoms like fatigue, frequent infections, anemia, bone pain, and unexplained weight loss. Treatment options vary depending on the type and stage of cancer but may include chemotherapy, radiation, stem cell transplantation, and targeted therapies. The prognosis and curability of bone marrow cancer depend on factors such as the specific type, stage, and individual patient characteristics.

- Chronic low oxygen levels (hypoxemia)

Hypoxemia is a low level of oxygen in the blood. It starts in blood vessels called arteries. Hypoxemia isn't an illness or a condition. It's a sign of a problem tied to breathing or blood flow.

- Spleen dysfunction

Spleen dysfunction, particularly in the form of an enlarged spleen (splenomegaly), can have various causes and symptoms:

Enlarged Spleen: An enlarged spleen can result from various underlying conditions. It may lead to discomfort or pain in the left upper abdomen, which can sometimes spread to the left shoulder or back. Common causes include infections, liver diseases, blood disorders, or other health conditions.

Symptoms: Enlarged spleen may not always present symptoms, but when they do occur, they can include fatigue, weight loss, frequent infections, easy bleeding, jaundice, and anemia.

Pain and Tenderness: Spleen dysfunction, such as a damaged or ruptured spleen, can cause pain or tenderness behind the left ribs. This can be an indicator of a problem with the spleen.

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