XML Print


1- Department of Pathology, Post Graduate Institute of Child Health, Noida, India , neema.tiwari@sharda.ac.in
2- Department of Pathology, Santosh Medical College, Ghaziabad,India
3- Department of Pathology,School of medical science and research, Sharda University, Noida, India
Abstract:   (126 Views)
Introduction
Nucleated red blood cells (nRBC) are immature erythrocytes whose production is thought to be driven primarily by the interplay of hypoxia and erythropoietin (EPO) synthesis..It is classified as early onset neonatal sepsis(occurring with first 24 hours of life)or late onset neonatal sepsis(occurring after 48-72 hour).
We planned the study with the aim of analysing the cause for presence of nRBCs in peripheral blood of neonates sent for routine workup in the hematology Lab of Dept of Pathology,SMSR,Sharda University
Material and Method
Retrograde analysis of 27 CBC and peripheral blood smears of neonates was done  for a period of 1 month and clinical details, parameters for neonatal sepsis(NLR,PLR,LMR,IG) platelet counts and nRBC counts recorded and tabulated. For result tabulation we divided the neonatal samples into two groups 0-1 day and 2- 30 days
Results
The neonates had 17 males and 9 females. The markers for neonatal sepsis NLR ,LMR and IG were more in cases 2-30 days as compared to cases 0-1 day old. nRBCs were also raised in cases between 2-13 days old. We had 3 cases crossing nRBCs level of 200/100 WBC while 2 vases showed nRBC levels of 150/100 WBC.
Conclusion
We conclude that finding nRBCs in peripheral smear is an  important indicator of neonatal stress(sepsis/jaundice/hypoxic sepsis).
 
Full-Text [PDF 213 kb]   (47 Downloads)    
Research Article: Case Report | Subject: Others
Received: 2023/01/26 | Accepted: 2024/06/1

References
1. Hermansen MC. Nucleated red blood cells in the fetus and newborn. Arch Dis Child Fetal Neonatal Ed. 2001;84(3):F211-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Christensen RD, Henry E, Andres RL, Bennett ST. Reference ranges for blood concentrations of nucleated red blood cells in neonates. Neonatology 2011;99(4):289-94. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Christensen RD, Lambert DK, Richards DS. Estimating the nucleated red blood cell "emergence time" in neonates. J Perinatol. 2014;34(2):116-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Hanlon-Lundberg KM, Kirby RS. Nucleated red blood cells as a marker of acidemia in term neonates. Am J Obstet Gynecol. 1999;181(1):196-201. [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Kovalak EE, Dede FS, Gelisen O, Dede H, Haberal A. Non reassuring fetal heart rate patterns and nucleated red blood cells in term neonates. Arch Gynecol Obstet. 2011;283(5):1005-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Baschat AA, Gembruch U, Reiss I, Gortner L, Harman CR. Neonatal nucleated red blood cell count and postpartum complications in growth restricted fetuses. J Perinat Med. 2003;31:323e9. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Boskabadi H, Zakerihamidi M, Sadeghian MH, Avan A, Ghayour Mobarhan M, Ferns GA. Nucleated red blood cells count as a prognostic biomarker in predicting the complications of asphyxia in neonates. J Matern Fetal Neonatal Med. 2017;30(21):2551-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Li J, Kobata K, Kamei Y, Okazaki Y, Nishihara M, Wada H, et al. Nucleated red blood cell counts: an early predictor of brain injury and 2-year outcome in neonates with hypoxic-ischemic encephalopathy in the era of cooling-based treatment. Brain Dev .2014;36(6):472-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Walsh BH, Boylan GB, Murray DM. Nucleated red blood cells and early EEG: predicting Sarnat stage and two year outcome. Early Hum Dev. 2011;87(5):335-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Silva AM, Smith RN, Lehmann CU, Johnson EA, Holcroft CJ, Graham EM. Neonatal nucleated red blood cells and the prediction of cerebral white matter injury in preterm infants. Obstet Gynecol. 2006;107(3):550-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Mandel D, Lubetzky R, Mimouni FB, Cohen S, Littner Y, Deutsch V, et al. Nucleated red blood cells in preterm infants who have necrotizing enterocolitis. J Pediatr. 2004;144(5):653-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
12. Bin-Nun A, Mimouni FB, Fink D, Sela H, Hammerman C. Elevated nucleated red blood cells at birth predict hemodynamically significant patent ductus arteriosus. J Pediatr. 2016;177:313-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. Dulay AT, Buhimschi IA, Zhao G, Luo G, Abdel-Razeq S, Cackovic M, et al. Nucleated red blood cells are a direct response to mediators of inflammation in newborns with earlyonset neonatal sepsis. Am J Obstet Gynecol. 2008;198(4):426.e1-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
14. Cremer M, Roll S, Graf C, Weimann A, Bu¨hrer C, Dame C. Nucleated red blood cells as marker for an increased risk of unfavorable outcome and mortality in very low birth weight infants. Early Hum Dev. 2015;91(10):559-63. [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Morton S, Bretten K, Feldman HA, Leeman KT. Association of nucleated red blood cell count with mortality among neonatal intensive care unit patients. Pediatr Neonatol. 2020:61(6);592-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Xanthou. Leucocyte blood picture in ill newborn babies. Arch Dis Child. 1972;47(255):741-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
17. Abhishek MG,Sanjay M. Diagnostic efficacy Nrbc count in early diagnosis of neonatal sepsis. IJPO. 2015;2(4);182-5. [View at Publisher] [DOI]
18. Tripathi S, Malik GK. Neonatal sepsis: past, present and future; a review article. Internet Journal of Medical Update. 2010;5(2):45-54. [View at Publisher] [DOI] [Google Scholar]
19. Purtle SW, Horkan CM, Moromizato T, Gibbons FK, Christopher KB. Nucleated red blood cells, critical illness survivors and post-discharge outcomes: a cohort study. Crit Care. 2017;21(1):154. [View at Publisher] [DOI] [PMID] [Google Scholar]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2007 All Rights Reserved | Medical Laboratory Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.