The NRBC blood test is ordered to count the nucleated red blood cells that are present. These cells are generally counted as white blood cells and the technique can happen through equipment or through a manual count. This blood test, sometimes referred to as a “blood smear” because a droplet of blood is pressed between two glass slides, is usually requested when a standard blood count comes back with an abnormal result.
This means the NRBC blood test is used more as a diagnostic tool instead of a discovery tool. In certain circumstances, however, it may be immediately ordered if there is the suspicion of a serious disease or life-threatening condition present. It is also regularly ordered to monitor the treatment plan of someone who has a blood cell disease.
What Are the Nucleated Red Blood Cells Doing?
When a person’s bone marrow senses that there are red blood cells that need to be replaced, it will begin to create new ones. This is when the nucleated red blood cells are formed. In most cases, these new cells are not released until they are mature enough to transport oxygen. Most people will not have them in their blood at all, which means a normal result would be 0.
This does not mean an abnormal result means there is something wrong. A small change can just be reflective of a single cell that was released too soon. It happens. When the counts are higher, however, it could mean that the bone marrow is working harder than it should to produce new red blood cells. It is that condition that doctors are hoping to find with this test.
What Do the Test Results Mean?
Although the NRBC blood test is used as a diagnostic tool, it does not always provide a definitive diagnosis. The test results from the counts of blood cells can mean any number of things if an abnormal result is present. Anyone who has had a recent blood transfusion or is on a high protein diet may see abnormal results even if no other underlying conditions are present.
Here are the most common causes of an abnormal result from the NRBC blood test.
1. The presence of an infection or inflammation somewhere within the body.
2. A dietary deficiency that has caused an anemia to develop.
3. The presence of hemoglobin variants, such as sickle cell anemia.
Sometimes the results can be abnormal because of medically insignificant issues, such as seasonal allergies. At other times, the results may be an indication that there is a serious underlying disease present. The NRBC blood test can detect the presence of leukemia, other bone marrow disorders, or the presence of neoplasms.
If your test results are abnormal and the NRBC was ordered as a follow-up to another abnormal test, then be sure to schedule an appointment with your doctor immediately to discuss the issue. If it has been ordered as part of a routine tracking of medical treatments, such as chemotherapy, then unless a doctor is concerned about the results, you shouldn’t be.
Having the Manual Test Count Is Important
Many laboratories have moved to an automated system of counting the blood cells that are present. This works find in most instances, but when there are platelet clumps or fragmented cells present in the sample, then the automatic equipment can generate a false positive. It is not uncommon for these items to be classified as white blood cells. The manual test count will help to determine the presence of cells or cell fragments for a more accurate count.
Any abnormal result, however, should be taken seriously. The appearance of these blood cells within circulation has been closely associated with a number of serious and severe diseases. Many wind up with a poor prognosis because of their abnormal test results. It can also be a marker for an inflammatory injury or hypoxia, so a discussion with a doctor is necessary.
An abnormal NRBC blood test can create a lot of fear. The added stress of that fear can further alter the results. Before coming to any conclusions, speak with your doctor and treatment team. There are statements that can be found on the internet that the appearance of a single NRBC can lead to death in as little as 3 days. These are for those who are already critically ill.
The number of conditions that can create the presence of NRBCs is vast. Only your doctor can tell you about the significance of your results. An abnormal result, however, should be investigated immediately.